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Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug.

Tanaka K, Yoshikawa R, Yanagi H, Gega M, Fujiwara Y, Hashimoto-Tamaoki T, Hirota S, Tsujimura T, Tomita N - World J Surg Oncol (2008)

Bottom Line: Very few Ki-67-positive cells were found.Non-cytotoxic treatment with etodolac (200 mg/day) was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer.Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 x 49 mm), and the disappearance of intratumoural septa.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. keita2s@hyo-med.ac.jp

ABSTRACT

Background: Desmoid tumours or fibromatoses are rare entities characterized by the benign proliferation of fibroblasts, which can be life-threatening due to their locally aggressive properties. Surgery is widely accepted as the first line of treatment for extra-abdominal desmoids; however, it is not recommended for intra-abdominal desmoids because of the high-risk of recurrence and difficulties with the operation. Here, we report on a patient with sporadic intra-abdominal desmoid tumours, who showed partial response following the intake of non-steroidal anti-inflammatory drugs.

Case presentation: A 73-year-old man presented with swelling and pain of the right leg. Computed tomography showed an abnormal multilocular soft-tissue mass (95 x 70 mm) in the right pelvis, which was revealed by biopsy to be a desmoid tumour. Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin, CD34, or desmin. Very few Ki-67-positive cells were found. Non-cytotoxic treatment with etodolac (200 mg/day) was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer. Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 x 49 mm), and the disappearance of intratumoural septa.

Conclusion: Our case report suggests that non-steroidal anti-inflammatory drug treatment should be taken into consideration for use as first-line treatment in patients with sporadic intra-abdominal desmoid tumours.

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Microscopic examination of biopsy specimen. Spindle-cellular tumours surrounded muscle components. The tumour cells had pale eosinophilic cytoplasms and chromatin structures, and were embedded in a collagen network interrupted by fibrotic sections. Scale bar represents 100 μm.
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Figure 2: Microscopic examination of biopsy specimen. Spindle-cellular tumours surrounded muscle components. The tumour cells had pale eosinophilic cytoplasms and chromatin structures, and were embedded in a collagen network interrupted by fibrotic sections. Scale bar represents 100 μm.

Mentions: Microscopic examination of the biopsy specimen revealed spindle-cellular tumours surrounding muscular elements. The tumour cells had a pale eosinophilic cytoplasm and chromatin structures, and were embedded in a collagen network interrupted by fibrotic sections (Figure 2). Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin (SMA), CD34, or desmin. Very few Ki-67-positive cells were found. After the diagnosis of desmoid tumour, analysis of β-catenin expression could not be undertaken because of an insufficient sample volume.


Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug.

Tanaka K, Yoshikawa R, Yanagi H, Gega M, Fujiwara Y, Hashimoto-Tamaoki T, Hirota S, Tsujimura T, Tomita N - World J Surg Oncol (2008)

Microscopic examination of biopsy specimen. Spindle-cellular tumours surrounded muscle components. The tumour cells had pale eosinophilic cytoplasms and chromatin structures, and were embedded in a collagen network interrupted by fibrotic sections. Scale bar represents 100 μm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2270274&req=5

Figure 2: Microscopic examination of biopsy specimen. Spindle-cellular tumours surrounded muscle components. The tumour cells had pale eosinophilic cytoplasms and chromatin structures, and were embedded in a collagen network interrupted by fibrotic sections. Scale bar represents 100 μm.
Mentions: Microscopic examination of the biopsy specimen revealed spindle-cellular tumours surrounding muscular elements. The tumour cells had a pale eosinophilic cytoplasm and chromatin structures, and were embedded in a collagen network interrupted by fibrotic sections (Figure 2). Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin (SMA), CD34, or desmin. Very few Ki-67-positive cells were found. After the diagnosis of desmoid tumour, analysis of β-catenin expression could not be undertaken because of an insufficient sample volume.

Bottom Line: Very few Ki-67-positive cells were found.Non-cytotoxic treatment with etodolac (200 mg/day) was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer.Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 x 49 mm), and the disappearance of intratumoural septa.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. keita2s@hyo-med.ac.jp

ABSTRACT

Background: Desmoid tumours or fibromatoses are rare entities characterized by the benign proliferation of fibroblasts, which can be life-threatening due to their locally aggressive properties. Surgery is widely accepted as the first line of treatment for extra-abdominal desmoids; however, it is not recommended for intra-abdominal desmoids because of the high-risk of recurrence and difficulties with the operation. Here, we report on a patient with sporadic intra-abdominal desmoid tumours, who showed partial response following the intake of non-steroidal anti-inflammatory drugs.

Case presentation: A 73-year-old man presented with swelling and pain of the right leg. Computed tomography showed an abnormal multilocular soft-tissue mass (95 x 70 mm) in the right pelvis, which was revealed by biopsy to be a desmoid tumour. Immunohistochemical analysis showed that the tumour cells expressed vimentin, but not smooth-muscle actin, CD34, or desmin. Very few Ki-67-positive cells were found. Non-cytotoxic treatment with etodolac (200 mg/day) was chosen because of the patient's age, lack of bowel obstruction, and the likelihood of prostate cancer. Two years after the commencement of non-steroidal anti-inflammatory drug administration, computed tomography showed a decrease in tumour size (63 x 49 mm), and the disappearance of intratumoural septa.

Conclusion: Our case report suggests that non-steroidal anti-inflammatory drug treatment should be taken into consideration for use as first-line treatment in patients with sporadic intra-abdominal desmoid tumours.

Show MeSH
Related in: MedlinePlus