Desmoid tumour, a rare tumour in oncology practice: A case series and literature review

Desmoid tumour, a rare tumour in oncology practice: A case series and literature review

Aim: Desmoid tumors (DTs) are very rare tumors that grow gradually anywhere in the body they are locally aggressive, but with a low potential for metastasis. Very good results can be obtained with different combinations of treatments, such as surgery, chemotherapy, hormonal therapy, tyrosine kinase inhibitor therapy and radiotherapy. Case series even with a small number of patients are of considerable importance as experience with DTs limited. Therefore, in this study, we aimed to discuss the management of DTs with our case series. Materials and Methods: In our study, 15 patients with DT, who were treated and followed up between January 2005 and January 2020 in two hospital medical oncology departments in Turkey, were evaluated. Results: The median age of diagnosis of the patients was 34 (range 18-48) years. Seven (46.6%) of the patients were female and eight (53.4%) were male. Seven (46.6%) of the tumors were located in the abdominal wall, four (26.7%) were in the limbs three (20%) were in the intra-abdominal area, and one (6.7%) was in the chest wall. In terms of resectability, 14 (93.3%) were resectable, and one (6.7%) was unresectable. The five-year overall survival rate was 73.85%, and the average disease-free survival time until relapse was 35 (range 15-83) months in patients who relapsed. The two- and five-year relapse-free survival rates were 90.9% and 66.5%, respectively. The median progression-free survival (PFS) for first-line treatment was 25 (range 8.6-89.8) months. The median PFS for second-line treatment was seven (range 4.3-38.0) months. In the one patient who received third-line treatment, PFS was 8.3 months. Conclusion: Frequent relapses in DTs are still the biggest problem in treating this disease. Although surgery treatment is the main treatment method used in desmoid tumors, controversy about adjuvant therapy after surgery continues, and new treatment modalities are required.

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  • 1. Mitchell G., Thomas JM., Harmer CL. Aggressive fibromatosis: Evidence for a stable phase. Sarcoma 1998;2:149-54.
  • 2. Kasper B, Ströbel P, Hohenberger P. Desmoid tumors: Clinical features and treatment options for advanced disease. The Oncologist 2011;16:682-93.
  • 3. Kallam AR, Ramakrishna BV, Roy GK, et al. Desmoid tumours: Our experience of six cases and review of literature. J Clinical & Diagnotic Research 2014;8: NE01-04.
  • 4. Mankin HJ, Hornicek FJ, Springfield DS. Extraabdominal desmoid tumors: a report of 234 cases. J Surg Oncol 2010;102:380-4.
  • 5. Klemmer S, Pascoe L, DeCosse J. Occurrence of desmoids in patients with familial adenomatous polyposis of the colon. Am J Med Genet 1987;28:385- 92.
  • 6. Skubitz KM. Biology and treatment of aggressive fibromatozis or desmoid tumor. Mayo Clin Proc 2017;92:947-64.
  • 7. Fiore M, MacNeill A, Gronchi A, et al..Desmoid-type fibromatosis: Evolving treatment standards. Surg Oncol Clin N Am 2016;25:803-26.
  • 8. Nicolas P, Frederic C, Sebastien S. Adult desmoid tumors: Biology, management and ongoing trials. Current. Opinion in Oncology 2017;29:268-74.
  • 9. Penel N, Coindre JM, Bonvalot S, et al. Management of desmoid tumours: A nationwide survey of labelled reference centre networks in France. Eur J Cancer 2016;58:90-9.
  • 10. Van Broekhoven DL, Verhoef C, Elias SG, et al. Local recurrence after surgery for primary extra-abdominal desmoid-type fibromatosis. Br J Surg 2013;100:1214- 9.
  • 11. Sakorafas GH, Nissotakis C, Peros G, et al. Abdominal desmoid tumors. Surgical Oncology 2007;16:131-42.
  • 12. Papagelopoulos PJ, Mavrogenis AF, Mitsiokapa EA, et al. Current trends in the management of extraabdominal desmoid tumours. World J Surg Oncol 2006;4:21
  • 13. Crago AM, Denton B, Salas S, et al. A prognostic nomogram for prediction of recurrence in desmoid fibromatosis. Ann Surg 2013;258:347-53.
  • 14. Lazar AJF, Hajibashi S, Lev DC, et al Desmoid tumor: From surgical extirpation to molecular dissection. Curr Opin Oncol 2009;21:352-9.
  • 15. Salas S, Dufresne A, Bui B, et al. Prognostic factors influencing progression-free survival determined from a series of sporadic desmoid tumors: A wait-and-see policy according to tumor presentation. J Clin Oncol 2011;29:3553-8
  • 16. Bonvalot S, Eldweny H, Haddad V, et al. Extraabdominal primary fibromatosis: Aggressive management could be avoided in a subgroup of patients. Eur J Surg Oncol 2008;34:462-8.
  • 17. Ballo MT, Zagars GK, Pollack A et al. Desmoid tumor: prognostic factors and outcome after surgery, radiation therapy, or combined surgery and radiation therapy. J Clin Oncol 1999;17:158-67.
  • 18. Peng PD, Hyder O, Mavros MN, et al. Management and recurrence patterns of desmoids tumors: a multiinstitutional analysis of 211 patients. Ann Surg Oncol 2012;19:4036-42.
  • 19. Bonvalot S, Eldweny H, Haddad V, et al. Extra-abdominal primary fibromatosis: Aggressive management could be avoided in a subgroup of patients. Eur J Surg Oncol 2008;34:462-8.
  • 20. Gentile MS, Jacobson A, Wang H, et al. Outcomes in patients with recurrent desmoid tumor managed with surgery alone, combined surgery and radiation therapy, or radiation therapy. International J Radiation Oncology Biology Physics 2016;96: 704-5  
  • 21. Bertagnolli MM, Morgan JA, Fletcher CD, et al. Multimodality treatment of mesenteric desmoid tumours. Eur J Cancer 2008;44:2404.
  • 22. Monneur A, Chetaille B, Perrot D, et al. Dramatic and delayed response to Doxorubicin-dacarbazine chemotherapy of a giant desmoid tumor: Case report and literature review. Case Rep Oncol 2013;6:127-33.
  • 23. Skapek SX, Ferguson WS, Granowetter L, et al. Vinblastine and methotrexate for desmoid fibromatosis in children: Results of a pediatric oncology group Phase II Trial. J Clin Oncol 2007;25:501-6.
  • 24. Garbay D, Cesne AL, Penel N, et al. Chemotherapy in patients with desmoid tumors: A study from the French sarcoma group (FSG). Ann Oncol 2012;23:182-6.
  • 25. Palassini E, Frezza AM, Mariani L, et al. Long-term efficacy of methotrexate plus vinblastine/vinorelbine in a large series of patients affected by desmoid-type fibromatosis. Cancer J 2017;23:86-91.
  • 26. Eastley N, McCulloch T, Esler C, et al. Extra-abdominal desmoid fibromatosis: A review of management, current guidance and unanswered questions. Eur J Surg Oncol 2016;42:1071-83.
  • 27. Signoroni S, Frattini M, Negri T, et al. Cyclooxygenase2 and platelet-derived growth factor receptors as potential targets in treating aggressive fibromatosis. Clin Cancer Res 2007;13:5034-40. .
  • 28. Aitken SJ, Presneau N, Kalimuthu S, et al. Nextgeneration sequencing is highly sensitive for the detection of beta-catenin mutations in desmoid-type fibromatoses. Virchows Archiv :An İnternational J Patology 2015;467:203-10.
  • 29. Misemer BS, Skubitz AP, Manivel JC, et al. Expression of FAP, ADAM12, WISP1, and SOX11 is heterogeneous in aggressive fibromatosis and spatially relates to the histologic features of tumor activity. Cancer Med 2014;3:81-90.
  • 30. Kotiligam D, Lazar AJF, Pollock RE, et al. Desmoid tumor: A disease opportune for molecular insights. Histol Histopathol 2008;23:117-26.
  • 31. Skapek XS, Anderson JR, Hill DA, et al. Safety and efficacy of high-dose tamoxifen and sulindac for desmoid tumor in children: Results of a children’s oncology group (COG) phase II study. Pediatric Blood &Cancer 2013;60:1108-12.
  • 32. Brooks MD, Ebbs SR, Colletta AA, et al. Desmoid tumours treated with triphenylethylenes. Eur J Cancer 1992;28A:1014-8.
  • 33. Tsukada K, Church J M , Jagelman D G , et al. Noncytotoxic drug therapy for intra-abdominal desmoid tumor in patients with familial adenomatous polyposis. Dis Colon Rectum 1992;35:29-33.
  • 34. Quast DR, Schneider R, Burdzik E, et al. Long-term outcome of sporadic and FAP-associated desmoid tumors treated with high-dose selective estrogen receptor modulators and sulindac: A single-center long-term observational study in 134 patients. Familial Cancer 2016;15:31-40.
  • 35. Penel N , Cesne AL, Bui BN, et al. Imatinib for progressive and recurrent aggressive fibromatosis (desmoid tumors): An FNCLCC/French Sarcoma Group phase II trial with a long-term follow-up. Ann Oncol 2011;22:452-7.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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