title: Primary or recurring extra-abdominal desmoid fibromatosis: assessment of treatment by observation only.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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 14 months; 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 (23 months). The sole factor impacting potential for evolution was prior surgery. No radiologic or pathologic criteria of evolution emerged from analysis.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Level IV, retrospective study.
authors.affiliation: Orthopedic Surgery and Traumatology Department, Cochin Hospital, AP-HP, René-Descartes University, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. olive.barbier@gmail.com
authors.forename: O
authors.initials: O
authors.lastname: Barbier
authors.forename: P
authors.initials: P
authors.lastname: Anract
authors.forename: E
authors.initials: E
authors.lastname: Pluot
authors.forename: F
authors.initials: F
authors.lastname: Larouserie
authors.forename: F
authors.initials: F
authors.lastname: Sailhan
authors.forename: A
authors.initials: A
authors.lastname: Babinet
authors.forename: B
authors.initials: B
authors.lastname: Tomeno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005350:Fibroma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018222:Desmoid Tumors / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D019370:Observation; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D055815:Young Adult