Results of Surgical Treatment of Anterior Abdominal Wall Desmoid Tumours: 13 Cases Reviewed with Literature

Abstract

Background : We retrospectively evaluated the results of surgical treatment for anterior abdominal wall desmoid tumours.

Methods : Records for 13 patients operated on for desmoid tumours from 1997-2013 were searched for age, gender, abdominal/pelvic surgical history, pregnancy, Gardner's syndrome, pre-operative radiological examinations, tumour size, multifocality, surgical procedure, tumour presence at surgical margins, recurrence, morbidity, and mortality. Local recurrence-free survival probabilities were estimated by the Kaplan-Meier method and stratified by various clinicopathological variables.

Results : There were 11 female (84,6%) and 2 male (15,4%) patients with a median age of 36 years. Seven (53,8%) patients had previous abdominal/pelvic surgery, five (38,5%) had a history of pregnancy, and one (7,6%) had Gardner's Syndrome. Two (15,3%) patients had multifocality on their pre-operative radiological examinations. Mean tumour diameter was 4,6 cm (SD 3,2 cm; range 2-12 cm). After the excision of the masses in five (38,5%) patients, synthetic materials were used to close the abdominal wall defects. Two (15,3%) patients with positive surgical margins after surgery were re-operated. Three (23%) patients required a second surgical intervention after the mass excisions were performed. Mean follow-up time was 56,7 months. Recurrence was observed in three patients during follow-up. Increased tumour size, history of previous abdominal/pelvic surgery, and the presence of multifocality had a negative effect on local recurrence-free survival. There was no mortality during follow-up.

Conclusions : Desmoid tumours are characterized by high recurrence, even after proper surgical excisions. Preoperative differential diagnoses of these tumours should be done and a post-operative follow-up protocol should be followed.