Multifocal extra-abdominal desmoid tumor--diagnostic and therapeutic problems

Area of Science:

• Orthopedic Surgery
• Oncology
• Radiology

Background:

• Desmoid tumors, also known as aggressive fibromatosis, are rare soft tissue neoplasms.
• Post-surgical complications can include tumor development in scar tissue.
• Spine stabilization surgery carries inherent risks and potential long-term sequelae.

Observation:

• An 18-year-old female presented with multifocal desmoid tumors one year post-spine injury surgical stabilization.
• Tumors were located in the surgical scar region and on the left scapula.
• Magnetic resonance imaging (MRI) indicated a questionable recurrence at the scar site.

Findings:

• Non-oncological resection of both desmoid tumors was performed.
• Positron emission tomography (PET) did not clarify the local tumor status.
• A 'wait-and-see' approach was adopted due to the risks associated with re-resection and radiation therapy.

Implications:

• This case highlights a rare presentation of desmoid tumors post-spinal surgery.
• The diagnostic challenges in differentiating tumor recurrence from scar tissue are noted.
• Management decisions require careful consideration of surgical risks, radiation toxicity, and patient outcomes.