Clinical features and long‐term outcomes of aggressive fibromatosis of the abdominal wall after surgical resection: A retrospective study and literature review

Wang, Kewei; Zhang, Jiaqi; Dong, Ming

doi:10.1111/ajco.13525

Cited by 4 publications

(2 citation statements)

References 35 publications

(43 reference statements)

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“…Reports indicate that approximately one-third of patients under AS eventually require other active treatment modalities. [ 25 ] In present case, the patient experienced recent progressive enlargement of a rectus abdominis DT, which led to significant abdominal pain. The patient declined further observation and strongly requested surgical intervention.…”

Section: Discussionmentioning

confidence: 72%

Desmoid tumors of rectus abdominis: A case report and literature review

Guo,

Zhang,

et al. 2024

Medicine

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Rationale: Desmoid tumor (DT) is a rare soft tissue tumor that can occur anywhere in the body. Abdominal wall DT presents unique clinical challenges due to its distinctive manifestations, treatment modalities, and the lack of biomarkers for diagnosis and recurrence prediction, making clinical decisions exceedingly complex. Patient concerns: A 32-year-old female who underwent radical resection combined with patch reinforcement for rectus abdominis DT, successfully alleviating abdominal discomfort, with no recurrence during the 6-month follow-up after surgery. Diagnoses: Based on the imaging studies and medical history, the patient underwent radical surgical resection. Histopathology reveals that the tumor cells predominantly composed of proliferative fibroblasts with local collagen deposition. The lesional cells show positive staining for β-catenin, indicating a diagnosis of DT. Interventions: The patient underwent radical surgical resection with patch reinforcement to repair the abdominal wall defect. Pathology confirmed negative margins, achieving an R0 resection, and genetic testing identified a T41A mutation in CTNNB1. Consequently, no additional adjuvant therapy was administered postoperatively. Outcomes: The patient was discharged with the incision healing well after 3 days postoperation. Upon reexamination 6 months later, no recurrence or adverse complications were observed. Lessons: Abdominal wall DT treatment requires personalized plans from multidisciplinary team discussions. Genetic testing plays a crucial role in identifying novel biomarkers for abdominal wall DT. We have once again demonstrated the significant clinical significance of CTNNB1 mutations in the diagnosis and progression of abdominal wall DT. Additionally, genes such as CCND1, CYP3A4, SLIT1, RRM1, STIM1, ESR2, UGT1A1, among others, may also be closely associated with the progression of abdominal wall DT. Future research should delve deeper into and systematically evaluate the precise impact of these genetic mutations on treatment selection and prognosis for abdominal wall DT, in order to better guide patient management and treatment decisions.

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Section: Discussionmentioning

confidence: 72%

Desmoid tumors of rectus abdominis: A case report and literature review

Guo,

Zhang,

et al. 2024

Medicine

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“…However, the criteria of trauma postulated by Warren or Enzinger and Shiraki are not met. The pregnancy-related DT group also include DTs arising at a cesarean section scar 39,40 in 26 patients in our series. Interestingly, another four women had undergone in vitro fertilization via laparoscopy and had developed DT at the trocar site.…”

Section: Discussionmentioning

confidence: 99%

Trauma and sporadic desmoid tumor development: An approach toward real incidence and aspects of causality

Hohenberger,

Menge,

Hohenberger

et al. 2023

Cancer

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ObjectivesThe development of desmoid tumors (DT) is associated with trauma, which is an aspect with medicolegal relevance. The objective of this study was to analyze the proportion and type of trauma (surgical, blunt/fracture, implants), its lag time, and mutations of the CTNNB1 gene in patients with sporadic DT.MethodsWe analyzed a prospectively kept database of 381 females and 171 males, median age at disease onset 37.7 years (females) and 39.3 years (males) with a histologically confirmed DT. Patients with germline mutation of the APC gene were excluded. Details of the history particularly of traumatic injuries to the site of DT were provided by 501 patients.ResultsIn 164 patients (32.7%), a trauma anteceding DT could be verified with a median lag time of 22.9 months (SD, 7.7 months; range, 9‐44 months). A prior surgical procedure was relevant in 98 patients, a blunt trauma in 35 patients, a punctuated trauma (injections, trocar) in 18 patients, and site of an implant in 10 patients. In 220 patients, no trauma was reported (43.9%), and 58 females (11.6%) had a postpregnancy DT in the rectus abdominis muscle. In 42 patients (8.4%), data were inconclusive. The distribution of mutations in the CTNNB1 gene (codon 41 vs. 45) was similar in patients with and without a history of trauma before DT development.ConclusionsA significant subgroup of patients suffers from a trauma‐associated DT, predominantly at a prior surgical site including implants to breast or groin, accounting for 77.9% of the cases, whereas blunt trauma was responsible in 22.1%. We found no data to support that trauma‐associated DT have different molecular features in the CTNNB1 gene.

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