CASE REPORT
Aggressive fibromatosis of head and neck: Considerations on the optimal treatment method on the basis of case report
 
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1
Department of Otolaryngology, Provincial Specialist Children’s Hospital in Olsztyn, Poland
2
Department of Otolaryngology, Clinical University Hospital in Olsztyn, Poland
3
Department of Pathology, Provincial Specialist Children’s Hospital in Olsztyn, Poland
CORRESPONDING AUTHOR
Wacław Kopala   

Department of Otolaryngology, Provincial Specialist Children’s Hospital in Olsztyn, Żołnierska 18 A, 10-561 Olsztyn, Poland. Tel.: +4889 539 34 30.
Submission date: 2015-12-15
Acceptance date: 2016-05-28
Online publication date: 2017-02-28
Publication date: 2019-12-15
 
Pol. Ann. Med. 2017;24(1):48–51
 
KEYWORDS
ABSTRACT
Introduction:
The term fibromatosis refers to proliferation of fibrous tissue in the form of irregular nodules or soft tissue sarcoma. It is characterized by local malignancy with tendency to recurrence, significant hypertrophy of the mature connective tissue and lack of the ability to form distant metastases. Pathological lesions originate from fascial, muscle and tendinous tissue.

Aim:
The aim of this work is to analyze the efficacy and safety of the selected methods of treatment of aggressive fibromatosis on the basis of the presented case.

Case study:
A five-year-old boy was admitted to the Department of Otolaryngology of the Provincial Specialist Children’s Hospital in Olsztyn due to right sided cervical mass. Histological examination of biopsy material revealed aggressive fibromatosis. The child was previously treated for two years with systemic chemotherapy with methotrexate, vinblastine, vincristine, imatinib and tamoxifen with no improvement. Surgical tumor removal was performed on February 14, 2014. During the 18-month observation period no signs of tumor recurrence were observed.

Results and discussion:
In the treatment of aggressive fibromatosis various therapeutic methods are used, including radiotherapy, chemotherapy and surgery. The effects of chemotherapy and radiotherapy are frequently unsatisfying. These methods are associated with numerous complications and side effects, thus mode of treatment should be considered individually for each patient. In case of the presented patient surgical tumor removal was the best and the most effective treatment method.

Conclusions:
Surgery should be a treatment of choice, whereas chemotherapy and radiotherapy should be considered as alternative or complementary methods in the treatment of aggressive fibromatosis.

CONFLICT OF INTEREST
None declared.
 
REFERENCES (18)
1.
Wu C, Amini-Nik S, Nadesan P, Stanford WL, Alman BA. Aggressive fibromatosis (desmoid tumor) is derived from mesenchymal progenitor cells. Cancer Res. 2010;70(19):7690–7698.
 
2.
Abikhzer G, Bouganim N, Finesilver A. Aggressive fibromatosis of the head and neck: case report and review of the literature. J Otolaryngol. 2005;34(4):289–294.
 
3.
Goullner JR, Saul EH. Desmoid tumor: an utrastructural study of eight cases. Hum Pathol. 1980;11(1):43–50.
 
4.
Gabbiani G, Majno G. Dupuytren’s contracture: fibroblast contraction? An ultrastructural study. Am J Pathol. 1972;66(1):131–146.
 
5.
Burke AP, Sobin LH, Shekitka KM, Federspiel BH, Helwig EB. Intra-abdominal fibromatosis: a pathologic analysis of 130 tumors with comparison of clinical subgroups. Am J Surg Pathol. 1990;14(4):335–341.
 
6.
Fasching MC, Saleh J, Woods JE. Desmoid tumors of the head and neck. Am J Surg. 1998;156(4):327–333.
 
7.
Kruse AL, Luebbers HT, GrätzKW, Obwegeser JA. Aggressive fibromatosis of the head and neck: a new classification based on a literature review over 40 years (1968–2008). Oral Maxillofac Surg. 2010;14(4):227–232.
 
8.
Siegel NS, Bradford GR. Fibromatosis of the head and neck: a challenging lesion. Otolaryngol Head Neck Surg. 2000;123(3):269–275.
 
9.
Gronchi A, Casali L, Mariani S, et al. Quality of surgery and outcome in extraabdominal aggressive fibromatosis: a series of patients surgically treated at a single institution. J Clin Oncol. 2003;21(7):390–397.
 
10.
Jelinek JA, Stelzer KJ, Conrad E, et al. The efficacy of radiotherapy as postoperative treatment for desmoid tumors. Int J Radiat Oncol Biol Phys. 2001;50(1):121–125.
 
11.
Ballo MT, Zagars GK, Pollack A, Pisters PWT, Pollock RA. Desmoid tumor, prognostic factors and outcome after surgery, radiation therapy, or combined surgery and radiation therapy. J Clin Oncol. 1999;17(1):158–167.
 
12.
Zlotecki RA, Scarborough MT, Morris CG, et al. External beam radiotherapy for primary and adjuvant management of aggressive fibromatosis. Int J Radiat Oncol Biol Phys. 2002;54(1):177–181.
 
13.
Nuyttens JJ, Rust PF, Thomas CR Jr, Turrisi AT 3rd. Surgery versus radiation therapy for patients with aggressive fibromatosis or desmoid tumors: a comparative review of 22 articles. Cancer. 2000;88(7):1517–1523.
 
14.
Hoos A, Lewis JJ, Urisr MJ, et al. Desmoid tumors of the head and neck, a clinical study of a rare entity. Head Neck. 2000;22(8):814–821.
 
15.
Waddell WR, Gerncr RE, Reich MP. Nonsteroid antiinflammatory drugs and tamoxifen for desmoid tumors and carcinoma of the stomach. J Surg Oncol. 1993;22(3):197–211.
 
16.
Sørensen A, Keller J, Nielsen OS, Jensen OM. Treatment of aggressive fibromatosis: a retrospective study of 72 patients followed for 1–27 years. Acta Orthop Scand. 2002;73(2):213–219.
 
17.
Azzarelli A, Gronchi A, Bertulli R, et al. Low-dose chemotherapy with methotrexate and vinblastine for patients with advanced aggressive fibromatosis. Cancer. 2001;92(5):1259–1265.
 
18.
Heinrich MC, McArthur GA, Demetri GD, et al. Clinical and molecular studies of the effect of imatinib on advanced aggressive fibromatosis (desmoid tumor). J Clin Oncol. 2006;24(7):1195–1203.