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SURGICAL TREATMENT OF THORACIC DESMOID TUMORS

2023; Elsevier BV; Volume: 164; Issue: 4 Linguagem: Inglês

10.1016/j.chest.2023.07.167

1931-3543

Feriel Souissi, AMINA ABDELKBIR, HAZEM ZRIBI, MAHDI ABDENNADHER, S. Maazaoui, ADEL MARGHLI,

Sarcoma Diagnosis and Treatment

PURPOSE: Desmoid tumors are rare soft tissue tumors secondary to an infiltrating fibroblastic proliferation.Report the experience of our departement in desmoid tumors treatment. METHODS:We performed a retrospective study over 8 cases of thoracic desmoid tumors operated at the department of thoracic surgery of Abderrahmane Mami in Ariana, Tunisia over a period of 14 years between 2006 to 2020. RESULTS:The average age was 36 years old [6-67 years old] with a sex ratio M/F of 1,6.The lesion was parietal in 6 cases and intrathoracic in 2 cases.A complete resection was performed in all cases for the parietal lesions, taking away an average of two ribs with healthy resection limits.Reconstruction of the anterior chest wall was performed in one case by placement of a mersylene plate with cementoplasty.For the intrathoracic lesions, the patient with a left mediastinopulmonary process of 6 cm, had a resection of the mass by left posterolateral thoracotomy and the patient with a tissue process of the left pleural cavity filling the left upper thoracic orifice, had a complete resection by Cormier-Dartevelle-Grunenwald approach.For all the patients, the diagnosis was confirmed by histological study of the surgical specimen.The immediate postoperative course was marked by a chylothorax in one case.Only one patient presented a local recurrence after 1 year, for which he had radiotherapy.CONCLUSIONS: Desmoid tumors are aggressive fibromatoses because of their infiltrative nature with a high potential for recurrence.The diagnosis is difficult and should be evoked for any thoracic parietal mass.Surgery remains the cornerstone of therapy and the removal of these tumors should be as large as possible to avoid the risk of recurrence. CLINICAL IMPLICATIONS:The diagnosis of desmoid tumor should be evoked for any thoracic parietal mass.