Desmoid tumor mimics local recurrence of extremity sarcoma on MRI

Abstract

Background and Objectives: The development of desmoid fibromatosis after tumor resection may mimic local recurrence. To our knowledge, this phenomenon has not been reported after extremity sarcoma resection. We report four cases of desmoid-type fibromatosis ("desmoid tumors") mimicking local recurrence after extremity sarcoma resection. Methods:We retrospectively reviewed the records of patients treated for extremity sarcoma by our orthopedic oncology service from 2014 to 2019 and identified four patients with biopsy-proven desmoid tumors. We extracted clinical, pathologic, radiographic, and operative data for the primary neoplasms and desmoid tumors. Results: Four patients with postresection surveillance magnetic resonance imaging suspicious for local recurrence underwent further analysis showing desmoid tumors. Patients underwent image-guided needle biopsy, with specimens demonstrating fibromatosis-type histologic characteristics. Two cases were β-catenin positive. Desmoid tumors were managed with observation. No patient had experienced local or distant recurrence of the primary tumor at a mean follow-up of 30 months after resection (range, 23-34 months); none underwent surgery for symptoms of desmoid tumors.Conclusions: Desmoid tumors should be considered part of the differential diagnosis when assessing patients with radiographic concern for postresection local recurrence of extremity bone and soft-tissue sarcoma. An image-guided needle biopsy can inform diagnosis and management. K E Y W O R D S desmoid tumor, local recurrence, magnetic resonance imaging surveillance, sarcoma, tumor resection

Development, Validation, and Visualization of A Web-Based Nomogram for Predicting the Recurrence-Free Survival Rate of Patients With Desmoid Tumors

“…According to the latest Desmoid Tumor Management Guidelines published by "The Desmoid Tumor Working Group" and NCCN (Soft tissue sarcoma, 2020, V2) guidelines, DT can be followed by MRI or CT, especially MR I (12). Postoperative MRI images of recurrent DT mainly showed enhancement of T2-weighted, T2-FS and STIR sequence signals, accompanied by the enhancement of nodular or mass-like T1-weighted postcontrast sequence signals (35,36).…”

Multimodality Imaging Assessment of Desmoid Tumors: The Great Mime in the Era of Multidisciplinary Teams

“…Thanks to the multiparametric approach, the exceptional contrast resolution and the possibility to exploit several advanced sequences, magnetic resonance imaging is the diagnostic gold standard for the study, characterization and follow-up of extra-abdominal DTs, with a pivotal role for intra-abdominal ones [ 138 , 139 , 140 , 141 , 142 , 143 ]. Most advantages are evident in particular extra-abdominal lesions occurring in the extremities, head and neck, abdominal and chest wall and in lesions at mesenteric localization in patients allergic to contrast agents or in young patients to reduce radiation exposure [ 1 , 7 , 21 ].…”

“…Inexpensive; widely available; safe [111][112][113][114][115][116] Requires high spatial resolution to obtain sufficient anatomical detail for the detection of deep lesions and for targeting interventional procedures [80] Multiparametric approach; the exceptional contrast resolution; functional assessment [138][139][140][141][142][143]…”