Management of mesenteric desmoid tumours in familial adenomatous polyposis

Intra-abdominal desmoids are locally invasive fibrous tumours within the mesentery of the intestine. They occur in 4% to 13% of patients with familial adenomatous polyposis (FAP). Of 498 patients registered in the Steve Atanas Stavro FAP Registry at the Mount Sinai Hospital, Toronto, 53 (11%) had desmoids and 40 of them had mesenteric desmoids. There were 23 women and 17 men, and the mean age was 31 years. Most tumours were diagnosed after colectomy for FAP. Of the 40 patients 7 (18%) died of desmoid-related complications. Surgical excision of desmoids is hazardous and was associated with a recurrence rate of up to 85% in this study. Current research is directed at the role of antiestrogens in the fundamental mechanisms of cell growth and are now the subject of clinical trials.