Desmoid tumors of the anterior abdominal wall: results from a monocentric surgical experience and review of the literature.
BACKGROUND
Desmoid tumor, also known as aggressive fibromatosis, is a rare soft tissue tumor. For those cases localized in the anterior abdominal wall, radical resection and reconstruction with a mesh is indicated. Because the rarity of the disease, randomized trials are lacking, but in reported retrospective series, it is clear that although it is considered a benign lesion, local recurrence is not uncommon.


METHODS
We analyzed the records of 14 consecutive patients (3 men, 11 women, mean age 36 years, range 25-51 years) with desmoid tumor of the anterior abdominal wall treated at the European Institute of Oncology. The surgical strategy was the same in all cases: wide surgical excision and immediate plastic reconstruction with mesh after intraoperative confirmation by frozen sections of disease-free margins of >1 cm. We considered long-term outcomes by using the European Organization for the Research and Treatment of Cancer QLQ-C30 as an instrument to evaluate the overall quality of the treatment delivered to these patients.


RESULTS
No immediate postoperative complication was registered, and no patient developed recurrence after a median follow-up period of 55 months. Two women experienced mesh bulging within 1 year after the operation. The long-term mean global health status registered was 97 out of 100.


CONCLUSIONS
Radical resection aided by intraoperative margin evaluation via frozen sections followed by immediate mesh reconstruction is a safe procedure and can provide definitive cure without functional limitations for patients with desmoid tumors of the anterior abdominal wall.
Bertani
Emilio
E
European Institute of Oncology, Milan, Italy. emilio.bertani@ieo.it
Chiappa
Antonio
A
Testori
Alessandro
A
Mazzarol
Giovanni
G
Biffi
Roberto
R
Martella
Stefano
S
Pace
Ugo
U
Soteldo
Javier
J
Vigna
Paolo Della
PD
Lembo
Rosalba
R
Andreoni
Bruno
B
D034861:Abdominal Wall; D000328:Adult; D005260:Female; D018222:Desmoid Tumors / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D013526:Surgical Mesh