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Case Reports
. 2016 Jul 22;14(1):190.
doi: 10.1186/s12957-016-0944-z.

Complete remission of pancreatic head desmoid tumor treated by COX-2 inhibitor-a case report

Yu-Chieh Wang  1 , Jia-Uei Wong  2
Affiliations
Case Reports

Complete remission of pancreatic head desmoid tumor treated by COX-2 inhibitor-a case report

Yu-Chieh Wang et al. World J Surg Oncol. .

Abstract

Background: Desmoid tumors (DTs) are non-metastatic, locally aggressive neoplasms with high postoperative recurrence rates. The pancreas is an extremely rare location for DTs. The local control of DTs is challenging. Surgery and radiotherapy are currently the principal treatment modalities for DTs; however, some resections might not be radical, and radiotherapy has several drawbacks. Therefore, many studies have been focusing on the molecular pathways involved in DTs in order to develop molecular-targeted therapies or chemotherapy. Cyclooxygenase-2 (COX-2) has been demonstrated to play a role in the growth of DTs, and the pharmacologic blockade of COX resulted in decreased cell proliferation in desmoid cell cultures in vitro.

Case presentation: Herein, we report a 57-year-old woman who presented with recurrent epigastric pain and weight loss. An abdominal computed tomography scan showed an approximately 10-cm mass over the pancreatic head region and dilatation of the pancreatic duct. Tumor biopsy and bypass surgery were performed. A DT was confirmed on pathologic analysis. After resection, we prescribed treatment with the COX-2 inhibitor celecoxib. The patient showed complete remission and there was no local recurrence or distant metastasis within the 24-month follow-up period.

Conclusions: The outcome of this case study is encouraging, and long-term follow-up studies are required to establish the effect of treatment with celecoxib on the prognosis of DTs.

Keywords: Aggressive fibromatosis; Cyclooxygenase-2 inhibitor; Desmoid tumor; Non-steroidal anti-inflammatory drugs; Pancreatic head.

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Figures

Fig. 1
Fig. 1
Cystic part (1) and solid part (2) of the pancreatic head tumor
Fig. 2
Fig. 2
The tumor (1) was noted from the pancreas and T-colon (2) was just above the tumor with mesocolon compressed. Although the mass effect of tumor made the patient abdominal pain, bile duct was not compressed to cause obstructive jaundice and gallbladder (3) was not distended
Fig. 3
Fig. 3
Pathology showed positive staining for SMA, desmin, and beta-catenin. Desmoid tumor was confirmed in final diagnosis
Fig. 4
Fig. 4
Follow-up CT in 18 months later showed marked regression of pancreatic desmoid tumor under celecoxib treatment
See this image and copyright information in PMC

References

    1. Buitendijk S, van de Ven CP, Dumans TG, et al. Pediatric aggressive fibromatosis: a retrospective analysis of 13 patients and review of literature. Cancer. 2005;104(5):1090–9. doi: 10.1002/cncr.21275. - DOI - PubMed
    1. Latchford AR, Sturt NJH, Neale K, et al. A 10-year review of surgery for desmoid disease associated with familial adenomatous polyposis. Br J Surg. 2006;93:1258–64. doi: 10.1002/bjs.5425. - DOI - PubMed
    1. Roggli VL, Kim HS, Hawkins E. Congenital generalized fibromatosis with visceral involvement. A case report. Cancer. 1980;45:954–60. doi: 10.1002/1097-0142(19800301)45:5<954::AID-CNCR2820450520>3.0.CO;2-Q. - DOI - PubMed
    1. Bruce JM, Bradley EL, 3rd, Satchidanand SK. A desmoid tumor of the pancreas. Sporadic intra-abdominal desmoids revisited. Int J Pancreatol. 1996;19:197–203. - PubMed
    1. Nursal TZ, Abbasoglu O. Sporadic hereditary pancreatic desmoid tumor: a new entity? J Clin Gastroenterol. 2003;37:186–8. doi: 10.1097/00004836-200308000-00019. - DOI - PubMed

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