Two synchronous desmoids tumours of the thoracic wall: A case report

Desmoid tumour is a rare neoplasm that develops from the fascia and musculoaponeurotic tissue. These tumours tend to local invasion. Desmoid tumours are usually solitary. We present the first case of two synchronous desmoid tumours of the chest wall.

A 56-year-old male with no medical history presented a painless chest wall mass. CT scan showed a deep soft tissue mass infiltrating the pectoralis major and minor muscles with an invasion of the subclavian and axillary pedicles and a second tumour infiltrating the latissimus dorsi muscle. MRI has allowed for a better study of these two masses, and a surgical biopsy confirmed the diagnosis of a desmoid tumour. The surgical resection was intra-tumoural for the anterior mass to preserve the axillary and subclavian pedicles, and the tumour resection was marginal for the posterior tumour. The postoperative course was uneventful, and an adjuvant therapy based on Imatinib was performed. The tumour residue was stabilized for two years follow-up.

Desmoid tumours are considered a locally aggressive disease. Ultrasound, CT scan, and MRI have different roles in their diagnosis. But pathological diagnosis is the "golden standard" diagnosis of desmoid tumours. The treatment of desmoid tumours is still not standardized. Surgery is the best primary treatment, but sometimes oncological resection may not be possible because of extension to the vital structure. Adjuvant therapy, like Imatinib, had demonstrated encouraging results.

For desmoid tumours with vital or noble structure invasion, intra-tumoural resection associated with adjuvant therapy demonstrated encouraging results.