Management of a female with recurrence of fibromatosis of the chest wall adjacent to the breast: a case report

Abstract

Extra-abdominal desmoid tumor is a rare soft tissue tumor that is histologically benign, but may behave aggressively. This case report specifically describes the clinical, radiographic, and pathologic features of 27 year-old female who experienced a post-surgical recurrence of fibromatosis of the chest wall over a two-year period of time secondary to previous inadequate excision. The fibromatosis was found to be involving the lower-inner quadrant of her right breast and causing worsening pain. A surgical management strategy was successfully undertaken.

Figure 1

CT and MRI showed a mass on the right inferior chest wall and the general view of the specimen. A: Computed tomography showed a 10×5 cm mass on the right inferior chest wall that appeared to be in continuity with the right pectoralis major muscle and right rectus abdominis muscle. B: Magnetic Resonance Imaging of the breast and the chest confirmed a 9×4 cm mass in close proximity to the lower-inner quadrant of the right breast, with contact to the ribs. C: The surgically removed specimen was lobulated and 14x16x10 cm in size, containing a 10x12x8 cm tumor. D: Bisected tumor showed a grossly circumscribed tumor with white, whorled patterns and without necrosis.

Figure 2

Histological features. Section stained with hematoxylin and eosin reveals evenly spaced plump spindle cells arranged in intersecting fascicles and associated with mild to moderate amounts of collagen resembling keloid (A, B original magnification ×100). On immunohistochemical staining, the spindle cells were positive for muscle-specific actin (MSA) (C, original magnification ×400) and smooth muscle actin (SMA) (D, original magnification ×400).