Primary or recurring extra-abdominal desmoid fibromatosis: Assessment of treatment by observation only - 13/11/10

Doi : 10.1016/j.otsr.2010.07.007

O. Barbier ^a,^⁎ , P. Anract ^a, E. Pluot ^b, F. Larouserie ^c, F. Sailhan ^a, A. Babinet ^a, B. Tomeno ^a
^a Orthopedic Surgery and Traumatology Department, Cochin Hospital, AP–HP, René-Descartes University, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
^b Radiology Department, Cochin Hospital, AP–HP, René-Descartes University, 75014 Paris, France
^c Pathology Department, Cochin Hospital, AP–HP, René-Descartes University, 75014 Paris, France

Corresponding author.

connectez-vous ou créez un compte

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 13 November 2010
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Summary

Introduction

Extra-abdominal desmoid fibromatosis (EADF) is a benign tumoral condition, classically managed by more or less radical and sometimes mutilating excision. This treatment strategy is associated with a recurrence rate of nearly 50% according to various reports.

Hypothesis

EADF may show spontaneous stabilization over time.

Methods

A retrospective series of 26 cases of EADF managed by simple observation was studied to assess spontaneous favorable evolution and identify possible factors impacting evolution. Eleven cases were of primary EADF with no treatment or surgery, and 15 of recurrence after surgery with no adjuvant treatment. MRI was the reference examination during follow-up.

Results

Twenty-four cases showed stabilization at a median 14months; there were no cases of renewed evolution after stabilization. One primary tumor showed spontaneous regression, and one recurrence still showed evolution at end of follow-up (23months). The sole factor impacting potential for evolution was prior surgery. No radiologic or pathologic criteria of evolution emerged from analysis.

Discussion

The present series, one of the largest dedicated to EADF managed by observation, confirmed recent literature findings: a conservative “wait-and-see” attitude is reasonable and should be considered when large-scale resection would entail significant functional or esthetic impairment.