Author of

• 12853

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  P3.24 - Poster Session 3 - Supportive Care (ID 160)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12871

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    P3.24-018 - Chest wall desmoid tumor with rapid growth after the resection of lung cancer (ID 1207)

    09:30 - 09:30  |  Author(s): K. Ichise
    • Abstract

    Background
    Desmiod tumor (aggressive fibromatosis) is an aggressive fibroblastic proliferation of well-circumscribed, locally invasive, differentiated fibrous tissue. Chest wall desmoids account for approximately 20% of all desmoids tumors. The etiology of this tumors is unknown. Local inflammatory changes involved in the healing response after trauma have often been postulated as stimulating the development of desmiod tumors. Although distant spread has not been documented in long-term follow-up studies, these tumors have a strong propensity to recur locally after resection. Several authors have emphasized the use of external radiotherapy as an adjunct to surgery to improve local control.

    Methods
    A 62-year-old male underwent left upper lobectomy using an anterolateral approach. The postoperative diagnosis was pulmonary adenocarcinoma (pT1N0M0 stage1A). Two years after operation, a computed tomography showed the 65x45x25mm diameter mass on the left chest wall around the previous operative scar. Three months later, the mass rapidly enlarged 110x100x55mm in size. A desmoid tumor was suspected from the specimen of an incisional biopsy.Figure 1

    Results
    A Resection of the tumor with the chest wall (from the 2nd rib to the 4th rib) was performed. And thoracoplasty using a myocutaneous flap made of latissimus dorsi muscle with the 10th rib and a titanium plates and Composix Mesh was performed for a defect in the chest wall. Histopathological examination revealed a desmoid tumor. The specimen showed proliferation of spindle shape cells with collagen fibers. No mitoses were present. Tumor cells invaded to ribs and intercostals muscles but surgical margin was negative. Adjuvant radiation therapy with a total dose of 50.4Gy was administered to prevent local recurrence.

    Conclusion
    He is doing well without recurrence at 37months after surgery and radiation. Wide local excision with negative pathological margins is the treatment of choice for most desmoid tumors. Postoperative radiation may be a treatment of choice to prevent local recurrence because the development of local recurrence would result in mutilating reopreration with disfigurement or even amputation.