Imaging assessment of desmoid tumours in familial adenomatous polyposis: is state-of-the-art 1.5 T MRI better than 64-MDCT?

Hansmann, Annika; Bhandari, Santosh; Gupta, Arun; Burling, David; Rana, Shweta; Phillips, R. K. S.; Clark, Sue

doi:10.1259/bjr/42420290

Cited by 30 publications

(21 citation statements)

References 17 publications

(26 reference statements)

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“…DTs can be diagnosed at all ages, but the peak incidence is after the third decade, with 80% of diagnoses made before 40 years of age (21). The incidence of DTs in FAp is 800-to 1,000-fold higher than in the general population (22): DTs occur in between 10% (23) and 15% of patients with FAp (6).…”

Section: Epidemiologymentioning

confidence: 99%

Desmoid Tumors in Familial Adenomatous Polyposis

2017

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Section: Epidemiologymentioning

confidence: 99%

Desmoid Tumors in Familial Adenomatous Polyposis

2017

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“…Some remain stable for long periods and spontaneous regression has been reported, but many demonstrate locally aggressive behavior with a propensity to recur even after complete resection (46). About 10% show a pattern of relentless growth with marked morbidity and even mortality (59,62). Risk factors for worse prognosis include tumor size larger than 10 cm, extensive involvement of the small bowel, and bilateral hydronephrosis (54).…”

Section: Mesenteric Fibromatosismentioning

confidence: 99%

Solid Tumors of the Peritoneum, Omentum, and Mesentery in Children: Radiologic-Pathologic Correlation:From the Radiologic Pathology Archives

Em¹,

Dm²,

Am³

et al. 2015

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Intraperitoneal solid tumors are far less common in children than in adults, and the histologic spectrum of neoplasms of the peritoneum and its specialized folds in young patients differs from that in older patients. Localized masses may be caused by inflammatory myofibroblastic tumor, Castleman disease, mesenteric fibromatosis, or other mesenchymal masses. Inflammatory myofibroblastic tumor is a mesenchymal tumor of borderline biologic potential that appears as a solitary circumscribed mass, possibly with central calcification. Castleman disease is an idiopathic lymphoproliferative disorder that appears as a circumscribed, intensely enhancing mass in the mesentery. Mesenteric fibromatosis, or intra-abdominal desmoid tumor, is a benign tumor of mesenchymal origin associated with familial adenomatous polyposis. Mesenteric fibromatosis appears as a mildly enhancing, circumscribed solitary mass without metastases. Diffuse peritoneal disease may be due to desmoplastic small round cell tumor (DSRCT), non-Hodgkin lymphoma, or rhabdomyosarcoma. DSRCT is a rare member of the small round blue cell tumor family that causes diffuse peritoneal masses without a visible primary tumor. A dominant mass is typically found in the retrovesical space. Burkitt lymphoma is a pediatric tumor that manifests with extensive disease because of its short doubling time. The bowel and adjacent mesentery are commonly involved. Rhabdomyosarcoma may arise as a primary tumor of the omentum or may spread from a primary tumor in the bladder, prostate, or scrotum. Knowledge of this spectrum of disease allows the radiologist to provide an appropriate differential diagnosis and suggest proper patient management.

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“… have previously reported that mesenteric desmoid tumours were far more likely to be poorly defined than musculoskeletal desmoids on CT. Sinha et al . have reported that MRI is equivalent to CT for the detection of intra‐abdominal and extra‐abdominal fibromatoses in FAP and may be particularly appropriate for young patients with the advantage of avoiding radiation. On the other hand, MRI has been stated as the imaging of choice for truncal and extremity fibromatoses as they demonstrate low signal intensity on T1 sequences compared with muscle and hyperintense signal (more than muscle) on T2‐weighted images .…”

Section: Discussionmentioning

confidence: 99%

“…CT scan is the imaging modality of choice for cancer recurrence surveillance as in the five cases presented in this series. Brooks et al [38] have previously reported that mesenteric desmoid tumours were far more likely to be poorly defined than musculoskeletal desmoids on CT. Sinha et al [39] have E Two mesenteric deposits likely to be malignant, one 11 mm below the left renal vessels in the small bowel mesentery and a second in the descending colon…”

Section: Discussionmentioning

confidence: 99%

Not all abdominal masses after colorectal cancer surgery are malignant: intra‐abdominal fibromatosis masquerading as recurrence

et al. 2019

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Aim Intra‐abdominal fibromatosis is an unusual mesenchymal tumour that can be locally aggressive without any metastatic potential. Fibromatosis may simulate cancer recurrence on imaging surveillance for colorectal cancer follow‐up. The optimal treatment of recurrent peritoneal malignancy is cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Confirmatory biopsy of lesions suspicious for colorectal cancer recurrence may not be feasible, thereby rendering surgery the safest option. Our aim was to determine the incidence of fibromatosis in a cohort of patients undergoing CRS and HIPEC for suspected colorectal cancer recurrence. Methods One hundred and seventy‐one CRS and HIPEC cases were performed at our Peritoneal Malignancy Institute between February 2007 and October 2018 for colorectal peritoneal metastases and were included in a prospectively maintained database. Results A total of 49 (29%) of 171 cases were performed for primary colorectal cancer with peritoneal metastases, whereas 122 (71%) of 171 cases were performed for suspected colorectal cancer recurrence detected on surveillance imaging after primary colorectal cancer resection. On histological analysis of the resected specimen, five (4.1%) of 122 cases undergoing CRS and HIPEC for colorectal recurrence had fibromatosis. Conclusion Fibromatosis can masquerade as colorectal cancer recurrence. In this series it occurred with an incidence of 4.1% among a cohort of patients undergoing CRS and HIPEC for probable recurrence. Surgical resection may be the only option to confirm the diagnosis and rule out malignancy.

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Imaging assessment of desmoid tumours in familial adenomatous polyposis: is state-of-the-art 1.5 T MRI better than 64-MDCT?

Abstract: MRI is at least equivalent (and may be superior) to MDCT for the detection of desmoid tumours in FAP. Coupled with the advantage of avoiding radiation, it should be considered as the primary imaging modality for young FAP patients.

Cited by 30 publications

References 17 publications

Desmoid Tumors in Familial Adenomatous Polyposis

Desmoid Tumors in Familial Adenomatous Polyposis

Solid Tumors of the Peritoneum, Omentum, and Mesentery in Children: Radiologic-Pathologic Correlation:From the Radiologic Pathology Archives

Not all abdominal masses after colorectal cancer surgery are malignant: intra‐abdominal fibromatosis masquerading as recurrence

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