Postoperative radiotherapy in primary resectable desmoid tumors of the neck: a case–control study

A total of 68 patients with Desmoid tumors (DTs) of the neck region with or without postoperative RT between 1/2008 and 12/2017 were included. They were individually matched for factors including age, gender, tumor size and margin status with a cohort of patients who underwent operative without postoperative RT. For the study, 34 patients and 34 matched control subjects were identified. The two groups did not differ in terms of age (p?=?0.810), gender (p?=?0.328), tumor size (p?=?0.803) and margin status (p?=?0.799). Patients who received surgery plus RT had a significantly higher 3?year event-free survival (EFS) than those who received surgery alone (74.6% vs. 13.3%, P?<?0.001). Factors including postoperative RT and margin status were independent factors of EFS. The values of P were <0.001 and 0.003 and the hazard ratios (95% confidence interval) were 11.929 (4.732–30.072) and 0.299 (0.133–0.671), respectively. None of the patients treated with RT developed serious complications. According to our results, postoperative radiotherapy is an effective treatment in desmoid tumors of the neck. Multi-institutional and prospective studies are warranted to further validate our findings.

Overall, 39 of a total of 79 patients underwent an MRI follow-up scan after resection of primary aggressive fibromatosis (AF) for a minimum of 1 year. The recurrent tumor was examined for contrast agent behavior, appearance, and extent in MRI. The patients were divided into two groups: younger and older than 25 years of age. The median recurrence-free follow-up interval was 49 months. Sixteen patients had no recurrence, and in 15 patients the suspicion was later withdrawn. Recurrences occurred in eight patients (21%), thus a high sensitivity but a moderate specificity (0.561) for the MRI scan. Recurrences occurred significantly more often during the first 9 months of the follow-up scan and especially in patients < 25 years of age. There was no significance in the appearance of AF, with a fascicular character the most common feature of recurrent AF. The primary tumors were altogether significantly smaller than recurrent AF. Muscle edema occurred significantly more often in patients with recurrences than in patients without them. The status of resection (R0–2) had no impact on recurrent AF. We showed that MRI follow-up scans result in a high sensitivity but a moderate specificity for the detection of recurrent AF because the distinction between recurrent AF and posttherapeutic changes is often difficult. Further studies are needed to investigate the radiologic features of recurrent AF and risk factors detected on MRI.

This study reports on the case of a 30-year-old female patient with the retroperitoneal fibromatosis that had a history of uterine leiomyoma. During the operation, the ovarian arteries and veins were separated according to what was found during the procedure. A postoperative examination demonstrated good function and morphology of the ovary. A thorough review of academic journals combined with our collection of clinical data was conducted, which confirmed the double blood supply source to the ovaries. As a result of this exploration, a new surgical method is being proposed that is designed to protect the ovaries. By conducting this new procedure, the patientÂ’s disease was not only halted and ultimately cured, but results demonstrate that the method was also able to retain the shape and function of the ovary. The postoperative satisfaction of the patient was significantly improved.

Sarcoma is rare and heterogenous with various subtypes having a different prognostic. Desmoid is a tumour with a local aggressiveness; GIST with KIT mutation responds massively to target treatment a IMATINIB, whereas soft tissue sarcoma and leiomyosarcoma are very aggressive with poor response to systemic therapies. Interventional radiology plays an important role in the diagnosis of sarcomas with image-guided percutaneous core needle biopsy being the most commonly used biopsy technique in the diagnosis of sarcomas. Surgery is a mainstay of sarcoma treatment; the resection can be large. Indeed, resection objective is R0 because quality of surgical margins impacts local control and survival. Radiotherapy is possible in neoadjuvant or in adjuvant treatment to improve local control rate. Recently radiotherapy enhancer injected percutaneously in soft tissue sarcoma has proven benefit in increasing the rate of R0 complete surgical resection. Several studies showed better local control rate linked with post-operative radiotherapy. The decision making to use local therapies is complex, depends upon diverse presentations and histologies, and should always be taken in a multidisciplinary discussion. Today, percutaneous image-guided treatments with ablation technologies (radiofrequency ablation, cryotherapy, microwaves ablation) provide high rate of durable local control for small-sized malignant deposit in many organs including lung, liver and bones. Sarcoma must be managed by multimodality treatment in expert reference centres. Such management has a considerable impact on the prognosis.

A retrospective, single-institution review identified 23 patients (ages 16-77) with extra-abdominal desmoid tumors who received CT-guided percutaneous cryoablation as either a first-line (61%) or salvage (39%) treatment in 30 sessions between 2014 and 2018. Median maximal lesion diameter was 69?mm (11-209). Intent was curative in 52% and palliative in 48%. Contrast-enhanced cross-sectional imaging was obtained before and after treatment in addition to routine clinical follow-up. Technical success was achieved in all patients. The median follow-up was 15.4 months (3.5-43.4). Symptomatic improvement was demonstrated in 89% of patients. At 12 months, the average change in viable volume was ?-80% (range -100% to ?+?10%) and response by modified response evaluation criteria in solid tumors (mRECIST) was CR 36%, PR 36%, and SD 28%. No rapid postablation growth or track seeding was observed. Four patients underwent repeat cryoablation for either residual or recurrent disease. Two patients sustained a major procedural complication consisting of significant neuropraxia. Cryoablation for desmoid tumors demonstrates a high degree of symptom improvement and local tumor control on early follow-up imaging with relatively low morbidity.

A girl aged 2.5 years presented to her general practitioner (GP) with a firm lump on her left jaw. The child had not noticed any change; however, her mother had noticed a swelling over the past week with no antecedent trauma. Tha patient did not complain of pain, mastication or airway compromise, paraesthesia or abnormal facial movements. She had a genetically confirmed past medical history and family history of familial adenomatous polyposis (FAP). Clinically she had a firm immobile swelling of the left mandibular body measuring 12 x 9 mm with no soft tissue induration or skin changes.