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J Hand Surg Am. 2014 Sep;39(9):1761-5. doi: 10.1016/j.jhsa.2014.06.015. Epub 2014 Jul 18.

Desmoid tumors of the upper extremity.

Author information

  • 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
  • 2Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN. Electronic address: kakar.sanjeev@mayo.edu.

Abstract

PURPOSE:

To determine the outcomes of surgical excision with or without adjuvant treatment in the management of desmoid tumors of the upper extremity.

METHODS:

We retrospectively reviewed 52 patients with a histologically confirmed desmoid tumor in the upper extremity that was managed surgically. All patients presented between 1970 and 2011 and had a minimum 2-year follow-up.

RESULTS:

There were 25 males and 27 females with an average age of 37 ± 17 years. The most common location was the shoulder (n = 27). The most common symptom was a painful mass (n = 30). Average tumor size was 189 ± 371 cm(3). Negative margins (wide or marginal resection) were achieved in 43 patients. The 5-year disease-free interval was 57%. Patients with recurrence were younger than those without (31 vs 43 y). Postoperative radiotherapy increased the time to recurrence (2.6 vs 1.6 y) but ultimate disease-free interval at 5 years was similar in patients who did and did not receive radiotherapy. Compared with the preoperative evaluation, there was a significant reduction in patients reporting moderate or severe pain postoperatively.

CONCLUSIONS:

Desmoid tumors are locally aggressive fibrous tumors. Recurrence after surgical excision of a desmoid tumor in the upper extremity is common, especially in younger patients. Adjuvant radiation therapy tended to increase time to recurrence but not rate of recurrence.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Therapeutic IV.

Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Desmoid tumors

[PubMed - indexed for MEDLINE]
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