A case of chest wall desmoid tumor that received postoperative radiation therapy

Abstract

A 47-year-old woman was admitted on feeling a swelling on her left precordium. Chest CT revealed a 3×6 cm mass on the posterior surface of the pectoralis major muscle. Because perioperative frozen-section diagnosis revealed a desmoid tumor, we resected the tumor including the pectoralis major muscle, pectoralis minor muscle, and the periosteum of the clavicle where the tumor was in contact. Two years later, computed tomography (CT) revealed a mass with a growth tendency in the vicinity of the previously resected site, and the patient underwent reoperation with a diagnosis of recurrent desmoid tumor. The tumor showed invasive growth extending close to the axillary region and brachial plexus. To prevent nerve injury, we resected the tumor as much as possible and additionally performed radiation therapy after surgery. There was no evidence of recurrence 3 years and 8 months after reoperation. Although complete resection is important for the surgical management of desmoid tumors, it seems necessary to select the treatment option of resecting the tumor as much as possible in combination with other therapeutic modalities in cases where complete resection may lead to a significant deterioration of the postoperative quality of life, as in the present case.