DOI: http://dx.doi.org/10.18203/2349-2902.isj20203805

Management of the patient with fibromatosis of the left anterior chest wall

Saravanakumar Subbaraj, Sandeep Manohar

Abstract


Desmoid fibromatosis is a rare but locally aggressive tumour comprised of myofibroblasts. It is histologically benign but can behave aggressively. They do not have the ability to metastasize but can cause significant morbidity and mortality by local invasion. These tumours may occur anywhere on the body, but are commonly found on the abdominal wall and within the intestinal mesentery. Mutations in either the β-catenin or the adenomatous polyposis coli (APC) genes are usually the cause for the development of desmoid tumours with the former comprising the sporadic development of tumours and the latter being associated with familial adenomatous polyposis syndrome. Surgical resection with histologically negative margins has been the cornerstone of therapy for this disease, but this paradigm has begun to shift. It is now common to accept a microscopically positive margin after resection as recurrence rates may not be significantly affected. This case report intends to describe the clinical, diagnostic and pathologic features of a post-traumatic fibromatosis involving left side chest wall in a 45 years old female and causing worsening pain. The surgical management was successfully undertaken.


Keywords


Desmoid tumour, Fibromatosis, Post traumatic, Surgical resection

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References


Latchford AR, Sturt NJH, Neale K, Rogers PA, Phillips RKS. A 10-year review of surgery for desmoid disease associated with familial adenomatosis polyposis. Br J Surg. 2006;93(10):1258-64.

Smith AJ, Lewis JJ, Merchant NB, Leung DHY, Woodruff JM, Brennan MF. Surgical management of intra-abdominal desmoid tumours. Br J Surg. 2000;87:608-13.

Enzinger FM, Shiraki M. Musculo-aponeurotic fibromatosis of the shoulder girdle (extra-abdominal desmoid): analysis of thirty cases followed up for ten or more years. Cancer. 1967:20:1131-40.

MacKinnon JG, Neifeld JP, Kay S, Parker GA, Foster WC, Lawrence Jr W. Management of desmoid tumors. Surg Gynecol Obster. 1989;169(2):104-6.

Merchant NB, Lewis JJ, Woodruff JM, Leung DH, Brennan MF. Extremity and trunk desmoid tumors: a multifactorial analysis of outcome. Cancer. 1999;86:2045-52.

Allen PJ, Shriver CD: Desmoid tumors of the chest wall. Semin Thorac Cardiovasc Surg. 1999;11:264-9.

Andino L, Cagle PT, Murer B, Lu L, Popper HH, Salle FG, Sienko AE, Barrios R, Zander DS. Pleuropulmonary desmoid tumors: immunohistochemical comparison with solitary fibrous tumors and assessment of beta-catenin and cyclin D1 expression. Arch Pathol Lab Med. 2006;130(10):1503-9.

Baliski CR, Temple WJ, Arthur K, Schachar NS. Desmoid tumors: a novel approach for local control. J Surg Oncol. 2002;80(2):96-9.