title: Is wide resection obsolete for desmoid tumors in children and adolescents? Evaluation of histological margins, immunohistochemical markers, and review of literature.
abstract: Desmoid fibromatosis is a benign fibroblastic neoplasm with high recurrence rates predominantly observed in pediatric and adolescent patients. The use of wide resection margins has been discussed controversially in literature. In addition, data on non-surgical treatment is limited as phase III studies are still missing. Nineteen patients under the age of 18 years were identified. Tumor location, surgical treatment for primary or recurrent tumors, resection margins, medical neo-/adjuvant treatment, time to recurrence as well as immunohistochemical markers (estrogen receptor, ER α and β, progesterone and androgen receptors, somatostatin, Ki-67, c-kit, platelet-derived growth factor receptors, PDGFRs, α and β, β-catenin) were evaluated. The mean age at diagnosis was 6.6 years, with a mean follow-up of 114 months. Recurrences were detected in four out of nineteen patients. Surprisingly, the recurrence rate was not influenced by type of resection used (R0, R1/2). All samples were tested negative for ER α, somatostatin, and progesterone receptor. In contrast, a majority of tumors showed positive results for PDGFR α and β and β-catenin. No correlation between positive immunohistochemical markers and tumor recurrences was detectable. In conclusion, recurrence rates are not depending on resection type and immunohistochemical markers seem to behave differently in children and adolescents in contrast to adult patients.
authors.affiliation: Department of Orthopedic Surgery, Medical University of Graz , Graz , Austria.
authors.forename: Nora
authors.initials: N
authors.lastname: Woltsche
authors.forename: Magdalena M
authors.initials: MM
authors.lastname: Gilg
authors.forename: Lukas
authors.initials: L
authors.lastname: Fraissler
authors.forename: Bernadette
authors.initials: B
authors.lastname: Liegl-Atzwanger
authors.forename: Alfred
authors.initials: A
authors.lastname: Beham
authors.forename: Herwig
authors.initials: H
authors.lastname: Lackner
authors.forename: Martin
authors.initials: M
authors.lastname: Benesch
authors.forename: Andreas
authors.initials: A
authors.lastname: Leithner
mesh_terms: D000008:Abdominal Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D011125:Adenomatous Polyposis Coli / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018222:Desmoid Tumors / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: aggressive fibromatosis in children and adolescents; immunohistochemistry; recurrence; type of resection