Unique Treatment Considerations for Chest Wall Desmoid Tumor Invading the Breast (original) (raw)

An unusual case of chest wall desmoid tumor

Indian Journal of Surgery, 2010

Desmoid tumor of the chest wall are uncommon fibromatous tumors characterized by their local invasion and frequent recurrences. Extra-abdominal sites are mainly the shoulder girdle, the pelvic girdle and distal ends of the lower limbs. The chest wall represents 8–10% of cases and the tumor is exceptionally intrathoracic. We present here a rare case of a large desmoid tumor of left antero-lateral chest wall. In the presented case, wide excision of the tumor and chest wall reconstruction was done. There was no recurrence in 3 years of follow up.

Sporadic desmoid tumors of the chest: long-term follow-up of 28 multimodally treated patients

European Journal of Cardio-Thoracic Surgery, 2011

Introduction: Desmoids of the chest are extremely rare borderline tumors. Radical surgical resection is considered to be the primary treatment. Achieving negative margins is often a challenge. Cases with positive surgical margins are associated with high risk of local recurrence. Methods: A retrospective multicenter review was undertaken of 28 patients who underwent surgery for sporadically appearing desmoids of the chest between 1988 and 2008. Clinico-pathological data were investigated in detail. Authors have statistically analyzed the relationships between gender, age, tumor size, radicality of the first surgery, impact of the pharmacologic treatment, estrogen receptor positivity, and the development of local recurrences after a median follow-up period of 104 months. Results: Primary surgery was radical in 14 patients (50%). Mean pathologic diameter was 72.14 mm. Wide surgical excision was performed in 27 primary cases, out of which 10 cases (37%) were full-and 17 cases (63%) partial-thickness chest wall resections. Synthetic mesh stabilization was used in nine cases and soft tissue coverage in six patients. Morbidity rate was 25%. Recurrences were found in 63% of the cases, with a mean time of 30.5 months to first recurrences. Our investigation confirmed that microscopically free surgical margin of the first tumor resection significantly affected local tumor control. Conclusions: Because the radicality of the first surgical resection is of essential importance for long-time local control of chest desmoids, accurate preoperative diagnostics and well-planned aggressive surgical resection of the primary tumor is recommended. Due to the low incidence of desmoids, multicentric randomized investigations would be mandatory to establish evidence-based protocol for desmoid tumors.

Desmoid Tumors of the Chest Wall

Asian Cardiovascular and Thoracic Annals, 2006

Desmoid tumors are rare soft tissue neoplasms derived from fascial or musculoaponeurotic structures. These tumors are histologically benign but may behave aggressively at the local level with multiple recurrences after complete resection being common. Chest wall desmoids account for approximately 20% of all patients with desmoid tumors. Patients with these lesions are often asymptomatic and thus commonly present with lesions greater than 10 cm in size. The treatment for these neoplasms remains margin negative surgical excision, and, given the often large size at presentation, may require extensive chest wall resection. When this is required, chest wall reconstruction with either prosthetic material and/or autologous tissue may be performed. There may be recurrence in as many as 75% of patients. Neither adjuvant radiotherapy or chemotherapy have been shown to reduce the rate of recurrence. Recurrence should also be treated with surgical resection because patients who undergo complete surgical resection of recurrence are as likely to remain disease free after resection as patients who present with primary disease.

Chest wall and intrathoracic desmoid tumors: surgical experience and review of the literature

European journal of medical research, 2009

Desmoid tumors are fibroblastic/myofibroblastic neoplasms, which originate from musculo-aponeurotic structures and are classified as deep fibromatoses. Despite their benign histologic appearance and lack of metastatic potential, desmoid tumors may cause aggres?sive local infiltrations and compression of surrounding structures. They are often associated with female gender, familial adenomatous polyposis (FAP) and sporadically may occur at sites of previous trauma, scars or irradiation. Molecular studies have demonstrated that these patients are associated with a bi-allelic APC mutation in the affected tissue. Radical tumor resection with free margins remains the first therapy of choice. In cases with anatomical or technical limitations for a wide excision, radiation therapy represents a proven and effective alternative or supplementary treatment.

Toward a new strategy in desmoid of the breast?

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 2015

To report initial results of observation as well as surgery in patients with desmoid tumors (DTs) of the breast, a rare tumor for which data are scarce. The initial approaches were categorized as either front-line loco-regional treatment [(surgery or radiotherapy group, SRG) n = 20] or initial observation [(no surgery/no radiotherapy group, NSRG) n = 11]. A total of 27 women and 4 men were assessed between 1992 and 2013 and included in this study. Patient characteristics were adequately balanced in the 2 groups. Fifteen patients (48.4%) had a past history of breast surgery in the previous 24 months. The median initial DT size on MRI was 50 mm. The median follow-up was 36 months. In the SRG, 8/20 patients (40%) experienced recurrence. The median time to recurrence was 29 months. During the study period, 6 patients in the SRG (30%) received a mastectomy at the time of diagnosis (n = 3) or at relapse (n = 3), 7 patients (35%) received a thoracic wall resection and 8 patients (40%) rece...

Desmoid Tumor of the Breast : a Case Report and Review of the Literature

The International Annals of Medicine, 2017

Fibromatosis or desmoid tumor (DT) is a rare entity, which constitutes 0.02% of all tumors. Desmoid tumor is frequently locally aggressive with frequent recurrence even if without metastatic potential. Breast is an unusual location of this entity, and only a few cases of breast desmoid tumors have been reported. We present a case of a desmoid tumor of the left breast in a 24-years-old woman, with a review of the literature.

Intra-thoracic desmoid tumor

Lung India, 2012

Desmoid tumor of the chest wall are uncommon fibromatous tumors characterized by their local invasion and frequent recurrences. Extra-abdominal sites are mainly the shoulder girdle, the pelvic girdle and distal ends of the lower limbs. The chest wall represents 8-10% of cases and the tumor is exceptionally intrathoracic. We present here a rare case of a large desmoid tumor of left antero-lateral chest wall. In the presented case, wide excision of the tumor and chest wall reconstruction was done. There was no recurrence in 3 years of follow up.