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Agrawal et al. J Cancer Metastasis Treat 2017;3:139-43 Journal of
DOI: 10.20517/2394-4722.2017.02
Cancer Metastasis and Treatment

www.jcmtjournal.com
Case Report Open Access

Large chest wall fibromatosis with

challenging treatment plan

Rashi Agrawal, Prekshi Choudhary, Arun Kumar Goel, Vaishali Zamre, Sandeep Agarwal, Dinesh Singh

Department of Radiation Oncology, Surgical Oncology, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh 201012, Delhi NCR, India.
Correspondence to: Dr. Rashi Agrawal, Department of Radiation Oncology, Surgical Oncology, Max Super Speciality Hospital, W3, sector 1,
Vaishali, Ghaziabad, Uttar Pradesh 201012, Delhi NCR, India. E-mail: Drrashi.ag@gmail.com
How to cite this article: Agrawal R, Choudhary P, Goel AK, Zamre V, Agarwal S, Singh D. Large chest wall fibromatosis with challenging treatment
plan. J Cancer Metastasis Treat 2017;3:139-43.
ABSTRACT
Article history: The primary mode of treatment for desmoid tumors is surgical excision. However, high
Received: 03-01-2017 recurrence rates (39-79%) have been reported when surgery is used alone. The role of
Accepted: 28-04-2017 adjuvant radiotherapy after surgical resection of primary disease is controversial and
Published: 21-07-2017 should be based on a balanced discussion of potential morbidity from radiotherapy and
local recurrence. In this patient, the maximum dimension of tumor was 21 cm. This is a
Key words: larger chest wall fibromatosis than has been reported thus far, to the best of our knowledge.
Chest wall fibromatosis, In this case, post-operative margins were free, but in view of the large initial tumor size and
recurrence, potential morbidity in case of any future locoregional recurrence, post-operative adjuvant
radiotherapy
external beam radiation was delivered. An image guided intensity modulated radiotherapy
technique was chosen to spare adjacent breast and lung parenchyma, and tolerance of these
structures was well respected. This case provides insight into this treatment approach.

INTRODUCTION have the potential to erode bone and surrounding
blood vessels or nerves.
Desmoid tumors, also termed as aggressive
fibromatosis, are heterogeneous, benign tumors that In this report, we present the case of a patient with
originate from deep musculoaponeurotic structures. a large chest wall aggressive fibromatosis, 21 cm in
These rare tumors account for approximately 0.03- maximum dimension, who was treated with surgery
0.1% of all solid tumors and 3.6% of all fibrous tissue followed by adjuvant modern image guided radiation
neoplasms. Fibromatoses of the chest wall are rare therapy. Standard protocols and recent trends for the
[1]
and only represent 10% to 20% of all fibromatoses. [2,3] treatment of desmoid tumors are also discussed.
These neoplasms can display local infiltrative CASE REPORT
growth but due to their benign nature they do not
metastasize. Desmoid tumors are non-encapsulated A 24-year-old female presented with complaints
[4]
and tend to extend along fascial planes. They also of pain in the right lower chest for 2.5 months and

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