Desmoid tumors of the head and neck

Desmoid tumors of the head and neck are uncommon and associated with a posttreatment recurrence rate as high as 70 percent. This study was undertaken to determine cure rates achievable by surgery and radiotherapy and the factors influencing failure. A chart review of all patients at our institution with desmoid tumors of the head and neck from 1919 to 1982 was undertaken, and pertinent data were tabulated. Forty-eight patients were found with this problem. Average duration of symptoms was 1.6 years, and tumor size ranged from 1 to 12 cm (mean 5.1 cm). Average follow-up was 5.8 years. The most common site of occurrence was the neck (34 patients). Thirty-two patients underwent complete excision with 8 recurrences; 4 were reexcised with no further recurrence at last follow-up. Fourteen patients had incomplete excision with 12 recurrences. Radiotherapy was employed as the primary therapy in two patients; both experienced recurrence. Complete excision is the only effective treatment for desmoid tumors of the head and neck, resulting in a disease-free state in 75 percent of the patients (87 percent after reexcision). Involvement of the brachial plexus was the chief factor precluding complete excision. Radiotherapy was of very little value.