Background: Desmoid tumors are rare, benign, locally invasive neoplasms characterized by proliferation of fibroblasts without cytologic features of malignancy. Wide excision is the recommended primary therapy. Adjunctive radiation therapy may be helpful in patients with positive surgical margins or recurrence. Progestins and tamoxifen are noted to be beneficial in recurrent or inoperable desmoid tumors.Case Reports: A 20-year-old woman with desmoid tumors of the rectus muscles associated with pregnancy is treated by surgical excision alone. A 32-year-old woman with a paravaginal desmoid involving the levator ani muscle was successfully managed with a combination of surgical excision and adjunctive radiation therapy.Discussion: The optimal primary therapy for desmoid tumors is wide, radical, local excision. Other treatments have included radiation therapy, tamoxifen, medroxyprogesterone acetate, corticosteroids, antibiotics, phenylbutazone, indomethacin, ascor-bate, and cytotoxic chemotherapy agents. Desmoid tumors have been associated with Familial Adenoma-tous Polyposis and Gardner's Syndrome, suggesting a genetic predisposition to the disease. The occurrence of these tumors has also been associated with pregnancy and soft tissue trauma. Conclusion: Although historically the primary management of aggressive fibromatosis has been by surgical resection, the diffuse nature of this tumor with its overall benign-appearing histologic features often compromises the surgeon's ability to determine and achieve microscopically free, adequately wide surgical margins of resection. We review the role of adjuvant treatments.
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