Natural course of desmoid-type fibromatosis

J Orthop Sci. 2008 Jan;13(1):51-5. doi: 10.1007/s00776-007-1187-1. Epub 2008 Feb 16.

Abstract

Background: Desmoid-type fibromatosis is a locally aggressive tumor known to have high potential for local recurrence after resection, while it exhibits self-limiting behavior and shows growth arrest or spontaneous regression in many patients. Thus, its natural course is not well known, and the proper treatment has not yet been established.

Methods: We retrospectively reviewed clinical outcome and changes in tumor size in 11 consecutive patients with extremity and trunk desmoid-type fibromatoses, who were basically observed without any treatment after diagnosis.

Results: For two patients in whom the tumors were initially incorrectly diagnosed as other tumors, surgical resection was performed. For another two patients, surgical resections were performed in the follow-up periods due to tumor enlargement or joint contracture. In all four patients who underwent surgery, tumors recurred shortly after resection and re-resection was not performed. During the follow-up periods with a median length of 56 months, ten tumors eventually stopped growing, and three of them regressed spontaneously. At the time of final follow-up, ten patients were alive with residual disease without severe morbidity. In one patient, the tumor enlarged to over 30 cm in diameter with a substantial functional deficit.

Conclusions: Simple observation is a noninvasive and function-preserving treatment for desmoid-type fibromatosis.

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Desmoid Tumors / diagnostic imaging
  • Desmoid Tumors / pathology*
  • Desmoid Tumors / therapy
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Regression, Spontaneous
  • Outcome and Process Assessment, Health Care
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Tumor Burden