Desmoid tumors of the head and neck—A clinical study of a rare entity

Hoos, Axel; Lewis, Jonathan J.; Urist, Marshall J.; Shaha, Ashok R.; Hawkins, William G.; Shah, Jatin P.; Brennan, Murray F.

doi:10.1002/1097-0347(200012)22:8<814::aid-hed11>3.0.co;2-#

Cited by 78 publications

(73 citation statements)

References 30 publications

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“…Studies focusing on DTs of the head, neck, and spine further support the assertion that complete tumor resection with negative margins improve the chances of recurrence-free survival [22][23][24][25][26] (Table 1). These studies show either statistical significance or a trend toward lower recurrence rates in patients with aggressive surgical margins for head, neck, and spine DTs compared to patients with positive surgical margins.…”

Section: Resultsmentioning

confidence: 81%

“…When recurrence rates were compared in patients with grossly negative surgical margins and grossly positive surgical margins for head, neck, and spine DTs, two studies showed statistical significance (p < 0.05) for lower recurrence rate after gross total resection, and seven showed a trend toward lower recurrence rates in patients with gross total resection. A summary of the recurrence rates following grossly complete resections compared to grossly incomplete excisions in case series with DTs of the head and neck is presented [3,[22][23][24][25][26][27][28][29][30] (Table 1).…”

Section: Literature Reviewmentioning

confidence: 99%

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Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

Eichberg¹,

Urakov²,

Vanni³

2017

Clin Med Rev Case Rep

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Objective: To provide an overview of head, neck, and spine Desmoid Tumor (DT), to describe the case of a patient who underwent aggressive surgical resection of a large invasive cervical DT, and to analyze the DT literature. We discuss the importance of aggressive surgical margins in decreasing recurrence risk in head, neck, and spine DTs. Methods:A twenty-three-year-old female patient with history of a left cervical neurofibroma resection presented two years later with neck mass regrowth. The mass was aggressively resected, and occiput to T1 fusion was performed. Additionally, the head, neck, and spine DT literature was reviewed regarding surgical margin status and recurrence rate. A "N-1" Chi-squared test was used to compare proportions, between percentage of patients that experienced recurrence after gross total resection, and percentage of patients that experienced recurrence after subtotal resection, to determine statistical significance (p < 0.05).Results: Histologically, the lesion was shown to be a DT, with posterior paracervical spinal musculature invasion. The surgery was well tolerated with no complications. At eight years postoperative followup, the patient is doing well with no tumor recurrence. Nine studies were identified describing surgical margin status and recurrence rate of head, neck, and spine DT. When recurrence rates were compared in patients with grossly negative surgical margins and grossly positive surgical margins for head, neck, and spine DTs, two studies showed statistical significance (p < 0.05) for lower recurrence rate after gross total resection, and seven showed a trend toward lower recurrence rates in patients with gross total resection. Conclusion:DTs are difficult clinical entities to cure due to high recurrence rate after resection. Consistent with previous studies indicating that aggressive surgical margins are associated with a decreased risk of recurrence, we present a case report of a female patient who underwent aggressive resection of a large DT and remains tumor-free after eight years. Thus, we recommend aggressive surgical resection of head, neck, and spine DTs to minimize recurrence risk.

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Section: Resultsmentioning

confidence: 81%

Section: Literature Reviewmentioning

confidence: 99%

Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

Eichberg¹,

Urakov²,

Vanni³

2017

Clin Med Rev Case Rep

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“…The exact aetiology is still unknown with various factors like genetic, viral, hormonal (oestrogen), trauma and irradiation being proposed to cause it [4]. The presence of membrane-specific hormone receptors on the fibroblasts supports a hormonal-based theory and hormonal therapy for these cases are based on these findings.…”

Section: Discussionmentioning

confidence: 98%

Aggressive Fibromatosis of Head and Neck in a Child

Gupta

Nair

Nilakantan

et al. 2014

Indian J Otolaryngol Head Neck Surg

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Aggressive fibromatosis is a broad group of benign fibrous tissue proliferations of similar microscopic appearance that are intermediate in their biological behavior between benign fibrous tissues and fibrosarcomas. They are rare lesions accounting for less than 3 % of all soft tissue tumours. Usual site is extremity whereas head and neck fibromatosis is a rare occurrence. We present a case of aggressive fibromatosis of the infratemporal fossa in a child, which was treated by surgical excision with adjuvant hormonal therapy.

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“…Authors of other studies indicate that there are no predictive factors available to determine tumor recurrence rates, however. [4][5][6]14,17 A local recurrence rate of 35 to 65% has been reported in some studies. Therefore, most authors advocate GTR only if vital structures can be spared.…”

Section: Macfarlanementioning

confidence: 99%

“…1), with scanty or absent mitotic activity or other atypical cytological features. 1,5,17 Differentiation of this tumor type from fibrosarcoma is essential, as desmoid tumors do not possess the tendency for metastasis. However, their local invasion along facial planes is ubiquitous and often involves nearby vascular and/or neural structures.…”

Section: Macfarlanementioning

confidence: 99%

Extraabdominal desmoid tumors

Dafford

Kim

Nelson³

et al. 2007

FOC

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Object Desmoid tumors are fibrous, slow-growing, nonmalignant tumors with a low potential for metastasis. These lesions show a high propensity for infiltrative growth with local invasion. Methods The authors undertook a retrospective study of 15 desmoid tumors in 11 women and four men (ranging in age from 32 to 67 years; median 48 years) treated at their institution. This study included further resection for recurrent tumors in nine of 15 patients (60%). Results There were 13 patients (86%) with brachial plexus lesions, one patient (7%) with a lumbar plexus lesion, and one (7%) with a peroneal nerve lesion. There was a female predominance in the study group of 2.75:1. Four patients (27%) reported improvement in pain status, six (40%) reported no change from their preoperative pain levels, and five (33%) reported worsened pain symptoms. There was tumor recurrence in two patients (13%) leading to further surgical intervention. Conclusions This case series included many recurrent desmoid tumors of the brachial plexus. Most of these lesions were relatively large tumors, predominantly involved with the plexal elements adding to the challenge of the resection. Currently, function-sparing excision is considered the optimal treatment for desmoid tumors arising in extraabdominal sites. Adjunctive radiation or brachytherapy is reserved for a patient with further recurrence in whom resection would be disfiguring or in whom the disease is more refractory.

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Desmoid tumors of the head and neck—A clinical study of a rare entity

Cited by 78 publications

References 30 publications

Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

Aggressive Fibromatosis of Head and Neck in a Child

Extraabdominal desmoid tumors

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