title: Complete remission of pancreatic head desmoid tumor treated by COX-2 inhibitor-a case report.
abstract: BACKGROUND
  Desmoid tumors (DTs) are non-metastatic, locally aggressive neoplasms with high postoperative recurrence rates. The pancreas is an extremely rare location for DTs. The local control of DTs is challenging. Surgery and radiotherapy are currently the principal treatment modalities for DTs; however, some resections might not be radical, and radiotherapy has several drawbacks. Therefore, many studies have been focusing on the molecular pathways involved in DTs in order to develop molecular-targeted therapies or chemotherapy. Cyclooxygenase-2 (COX-2) has been demonstrated to play a role in the growth of DTs, and the pharmacologic blockade of COX resulted in decreased cell proliferation in desmoid cell cultures in vitro.
  
  
  METHODS
  Herein, we report a 57-year-old woman who presented with recurrent epigastric pain and weight loss. An abdominal computed tomography scan showed an approximately 10-cm mass over the pancreatic head region and dilatation of the pancreatic duct. Tumor biopsy and bypass surgery were performed. A DT was confirmed on pathologic analysis. After resection, we prescribed treatment with the COX-2 inhibitor celecoxib. The patient showed complete remission and there was no local recurrence or distant metastasis within the 24-month follow-up period.
  
  
  CONCLUSIONS
  The outcome of this case study is encouraging, and long-term follow-up studies are required to establish the effect of treatment with celecoxib on the prognosis of DTs.
authors.affiliation: Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan. drjuboy@gmail.com.
authors.forename: Jia-Uei
authors.initials: JU
authors.lastname: Wong
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D005260:Female; D018222:Desmoid Tumors / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D011379:Prognosis; D012074:Remission Induction
chemical_list: D052246:Cyclooxygenase 2 Inhibitors
keywords: Aggressive fibromatosis; Cyclooxygenase-2 inhibitor; Desmoid tumor; Non-steroidal anti-inflammatory drugs; Pancreatic head