Palliative Resection of a Giant Mesenteric Desmoid Tumor.

We present the case of a symptomatic, giant mesenteric desmoid tumor discovered incidentally during workup for the patient’s previous history of lung cancer. The patient elected to undergo palliative resection of the tumor because of persistent and unrelenting abdominal pain.

Solid and cystic pancreatic neoplasms are being recognized more frequently with increasing utilization and spatial resolution of modern imaging techniques. Schwannomas and desmoid tumors can be solid or cystic. The goal of this comprehensive review is to improve understanding of these rare primary pancreatic mesenchymal tumors.

Aim of this study is to evaluate the outcome of long-term conservative treatment with sulindac and high-dose selective estrogen receptor modulators (SERMs) for sporadic and FAP-associated desmoid tumors. This study included all desmoid patients that were treated and followed at our institution and had completed at least 1 year of treatment. Response was defined as stable size or regression of desmoid size between two CT or MRI scans. A total of 134 patients were included. 64 (47.8 %) patients had a confirmed diagnosis of FAP, 69 (51.5 %) patients were sporadic. Overall 114 (85.1 %) patients showed regressive or stable desmoid size. Patients with previous history of multiple desmoid-related surgeries showed less-favorable response. The mean time to reach at least stable size was 14.9 (±9.1) months. After regression or stabilization, medication was tapered in 69 (60.5 %) of the treated patients with only one long-term recurrence after >10 years. The results of this study fortify the role of sulindac and high-dose SERMs as an effective and safe treatment for both, sporadic and FAP-associated desmoid tumors. While invasive treatment frequently results in high recurrence rates, high morbidity and high mortality, this conservative treatment is successful in most patients.

Desmoid tumors of the pancreas are, however, very rare, and only a few cases have been reported in the literature. This paper reports an anecdotal case of a diffuse pancreatic desmoid tumor with the involvement of the pancreatic head, body, and-partially-tail.Â

High-intensity focused ultrasound (HIFU) is a minimally invasive and effective method for treatment of solid tumors. We used HIFU to treat four patients with intra-abdominaldesmoid tumors from June 2011 to September 2013. Post-procedural pain was seen in all patients. One patient had an intra-abdominal abscess and another suffered a slight injury to the femoral nerve. The patients were followed up for 19-46 months (mean 34 months) until April 2015. The tumor in one patient disappeared, and no tumor progression was observed in the other patients.

A 47-year-old female was referred to the hospital because of persistent pain at the ventral right side of the chest for several weeks. Contrast-enhanced CT of the chest confirmed the presence of a right-sided sharply delineated heterogeneous intra-thoracic mass with a broad pleural base. Because malignancy could still not be ruled out, a surgical biopsy was performed. Pathologic examination showed a fibromatous spindle cell lesion without signs of high grade malignancy. Histological and immunohistochemical image was strongly suggestive for desmoid tumor with staining negative for keratin, CD34 and S100 and positive for beta-catenin and actin. Surgery was recommended, but the patient rejected and chose radiotherapy. Follow-up imaging six months later showed slight volume loss of the tumor. The patient remains in further follow-up.