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. 2015 Feb 7:13:26.
doi: 10.1186/s12957-015-0450-8.

Postoperative recurrence of desmoid tumors: clinical and pathological perspectives

Yi-fei Wang  1 , Wei Guo  2 , Kun-kun Sun  3 , Rong-li Yang  4 , Xiao-dong Tang  5 , Tao Ji  6 , Shun Tang  7
Affiliations

Postoperative recurrence of desmoid tumors: clinical and pathological perspectives

Yi-fei Wang et al. World J Surg Oncol. .

Abstract

Background: The clinical features and the pathological changes of desmoid tumors were studied to point out the key factors affecting the recurrence.

Methods: The clinical data and specimens of 56 patients who underwent desmoid tumor resection from 2003 to 2008 were reviewed. Possible clinical factors related to the postoperative recurrence were analyzed statistically. The specimens round the lesions were studied histopathologically.

Results: The overall recurrence rate was 39.3%. The postoperative recurrence rate of the patients with negative surgical margins and no tumor invasion of the major vessels and nerves was low (P < 0.05). However, the desmoid tumors could destroy the cortical bone and invade the medullary cavity.

Conclusions: Desmoid tumors were pathologically benign, which could extensively invade tissues around the lesions. The invasion of major vessels and nerves and quality of surgical margins are the key factors for the high postoperative recurrence rate.

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Figures

Figure 1
Figure 1
Desmoid tumor in the proximal part of the left thigh of a 29-year-old woman. Macroscopically, desmoid tumors were yellowish white on the cut and often poorly circumscribed.
Figure 2
Figure 2
Histological features of desmoid tumors in the proximal part of the left thigh of a 29-year-old woman (arrows) (a–d). (a) Desmoid tumors invaded into the skeletal striated muscle aggressively. Degeneration of skeletal muscle cells could be seen (HE × 100). (b) Budding-like protrusion of the lesions invading into the muscles could be seen on the juncture of tumors and muscles (HE × 40). (c) Isolated small lesions in muscles were found away from the main part of the tumor (HE × 40). (d) Microscopically, desmoid tumors were poorly circumscribed on tumor-ligament boundary (HE × 40).
Figure 3
Figure 3
Histological features of postoperative recurrent desmoid tumors in the right forearm of a 15-year-old man (arrows) (a–d). (a) Lesions with adipose tissue involvement (HE × 40). (b) Desmoid tumors around vessels could not invade into the vessel wall to form tumor thrombus (HE × 40). (c) Desmoid tumors invaded into the connective tissue and perineurium around nerve tissue (HE × 40). (d) Desmoid tumors with bone involvement penetrated into the periosteum and cortical bone and invaded into the bone marrow cavity along the bone trabecula (HE × 40).
Figure 4
Figure 4
Immunological features of desmoid tumors in the middle section of the left thigh of a 35-year-old woman with femur involvement (a–d). (a) β-catenin staining of desmoid tumors (EnVision × 200). (b) Vimentin staining of desmoid tumors (EnVision × 200). (c) Desmin staining of desmoid tumors (EnVision × 200). (d) Ki-67 staining of desmoid tumors (EnVision × 200).
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