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Destructive invasion of the clavicle by desmoid tumor: a case report.

Togral G, Yildizgoren MT, Arikan M, Gungor S - Pan Afr Med J (2014)

Bottom Line: Desmoid tumors are rare, soft-tissue neoplasms that do not metastasize, but exhibit aggressive growth and local invasion.They originate most frequently from abdominal fascial structures, although they can also appear at extra-abdominal sites.The most common extra-abdominal locations include the shoulder, chest wall, back, thigh, and head and neck.

View Article: PubMed Central - PubMed

Affiliation: Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.

ABSTRACT
Desmoid tumors are rare, soft-tissue neoplasms that do not metastasize, but exhibit aggressive growth and local invasion. They originate most frequently from abdominal fascial structures, although they can also appear at extra-abdominal sites. The most common extra-abdominal locations include the shoulder, chest wall, back, thigh, and head and neck. In children, desmoid tumors are more infiltrative, having a tendency towards osseous involvement more frequently than in adult patients. We report acase of a supraspinatus muscle desmoid tumor in a female patient with clavicle destruction.

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Related in: MedlinePlus

(A) plain radiograph of left shoulder demonstrates a radiolucent area at the lateral edge of the clavicle(arrow); (B) axial T1-weighted MR image with fat suppression after intravenous gadolinium administration shows an enhancing mass with cortical disruption and invasion into the medullary space (arrow); (C) the intra-op image shows severe osseous destruction of the clavicle (arrow); (D) macroscopic view of the excised desmoid tumor
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Figure 0001: (A) plain radiograph of left shoulder demonstrates a radiolucent area at the lateral edge of the clavicle(arrow); (B) axial T1-weighted MR image with fat suppression after intravenous gadolinium administration shows an enhancing mass with cortical disruption and invasion into the medullary space (arrow); (C) the intra-op image shows severe osseous destruction of the clavicle (arrow); (D) macroscopic view of the excised desmoid tumor

Mentions: A 37-year-old woman presented with a pain in her left shoulder of six month's duration. She had no history of trauma or neoplasm. On physical examination, her shoulder range of motion was full, with intact motor and sensory functions in the upper limb; however, the lateral edge of the clavicle was tender with palpation. Radiographs of the left shoulder showed an osteolytic lesion located at distal 1/3 of the left clavicle (Figure A). On MR images, an axial T1-weighted image, with fat suppression after intravenous gadolinium administration, revealed a mass measuring 2.0cm x 2.5cm within the supraspinatus muscle, with apparent invasion of the medulla of the clavicle (Figure B). During surgery to remove the tumor, severe destruction of the clavicle was noted (Figure C). The mass was removed via a wide excision (Figure D). Histopathology revealed a dense, collagenous neoplasm, with irregular margins and a diffuse infiltrative growing pattern. The cells consisted of uniform myofibroblasts with vesiculated nuclei and abundant amphophilic cytoplasm, with an absence of mitotic activity or necrosis. An immunohistochemical test for beta-catenin was positive, and microscopic analysis was revealed a diagnosis compatible with the characteristics of a desmoid tumor. There were no surgical complications and no recurrence was detected after 12 months. The patient is receiving follow-up care in our department.


Destructive invasion of the clavicle by desmoid tumor: a case report.

Togral G, Yildizgoren MT, Arikan M, Gungor S - Pan Afr Med J (2014)

(A) plain radiograph of left shoulder demonstrates a radiolucent area at the lateral edge of the clavicle(arrow); (B) axial T1-weighted MR image with fat suppression after intravenous gadolinium administration shows an enhancing mass with cortical disruption and invasion into the medullary space (arrow); (C) the intra-op image shows severe osseous destruction of the clavicle (arrow); (D) macroscopic view of the excised desmoid tumor
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4430038&req=5

Figure 0001: (A) plain radiograph of left shoulder demonstrates a radiolucent area at the lateral edge of the clavicle(arrow); (B) axial T1-weighted MR image with fat suppression after intravenous gadolinium administration shows an enhancing mass with cortical disruption and invasion into the medullary space (arrow); (C) the intra-op image shows severe osseous destruction of the clavicle (arrow); (D) macroscopic view of the excised desmoid tumor
Mentions: A 37-year-old woman presented with a pain in her left shoulder of six month's duration. She had no history of trauma or neoplasm. On physical examination, her shoulder range of motion was full, with intact motor and sensory functions in the upper limb; however, the lateral edge of the clavicle was tender with palpation. Radiographs of the left shoulder showed an osteolytic lesion located at distal 1/3 of the left clavicle (Figure A). On MR images, an axial T1-weighted image, with fat suppression after intravenous gadolinium administration, revealed a mass measuring 2.0cm x 2.5cm within the supraspinatus muscle, with apparent invasion of the medulla of the clavicle (Figure B). During surgery to remove the tumor, severe destruction of the clavicle was noted (Figure C). The mass was removed via a wide excision (Figure D). Histopathology revealed a dense, collagenous neoplasm, with irregular margins and a diffuse infiltrative growing pattern. The cells consisted of uniform myofibroblasts with vesiculated nuclei and abundant amphophilic cytoplasm, with an absence of mitotic activity or necrosis. An immunohistochemical test for beta-catenin was positive, and microscopic analysis was revealed a diagnosis compatible with the characteristics of a desmoid tumor. There were no surgical complications and no recurrence was detected after 12 months. The patient is receiving follow-up care in our department.

Bottom Line: Desmoid tumors are rare, soft-tissue neoplasms that do not metastasize, but exhibit aggressive growth and local invasion.They originate most frequently from abdominal fascial structures, although they can also appear at extra-abdominal sites.The most common extra-abdominal locations include the shoulder, chest wall, back, thigh, and head and neck.

View Article: PubMed Central - PubMed

Affiliation: Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.

ABSTRACT
Desmoid tumors are rare, soft-tissue neoplasms that do not metastasize, but exhibit aggressive growth and local invasion. They originate most frequently from abdominal fascial structures, although they can also appear at extra-abdominal sites. The most common extra-abdominal locations include the shoulder, chest wall, back, thigh, and head and neck. In children, desmoid tumors are more infiltrative, having a tendency towards osseous involvement more frequently than in adult patients. We report acase of a supraspinatus muscle desmoid tumor in a female patient with clavicle destruction.

Show MeSH
Related in: MedlinePlus