Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug.
BACKGROUND
Desmoid tumours or fibromatoses are rare entities characterized by the benign proliferation of fibroblasts, which can be life-threatening due to their locally aggressive properties. Surgery is widely accepted as the first line of treatment for extra-abdominal desmoids; however, it is not recommended for intra-abdominal desmoids because of the high-risk of recurrence and difficulties with the operation. Here, we report on a patient with sporadic intra-abdominal desmoid tumours, who showed partial response following the intake of non-steroidal anti-inflammatory drugs.


METHODS
A 73-year-old man presented with swelling and pain of the right leg. Computed tomography showed an abnormal multilocular soft-tissue mass (95 x 70 mm) in the right pelvis, which was revealed by biopsy to be a desmoid tumour. Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin, CD34, or desmin. Very few Ki-67-positive cells were found. Non-cytotoxic treatment with etodolac (200 mg/day) was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer. Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 x 49 mm), and the disappearance of intratumoural septa.


CONCLUSIONS
Our case report suggests that non-steroidal anti-inflammatory drug treatment should be taken into consideration for use as first-line treatment in patients with sporadic intra-abdominal desmoid tumours.
Tanaka
Keita
K
Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. keita2s@hyo-med.ac.jp
Yoshikawa
Reigetsu
R
Yanagi
Hidenori
H
Gega
Makoto
M
Fujiwara
Yoshinori
Y
Hashimoto-Tamaoki
Tomoko
T
Hirota
Syozo
S
Tsujimura
Tohru
T
Tomita
Naohiro
N
D000008:Abdominal Neoplasms / Q000188:drug therapy*; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018221:Fibromatosis, Abdominal / Q000188:drug therapy*; D018222:Desmoid Tumors / Q000188:drug therapy*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal