Tuberc Respir Dis.  2015 Jul;78(3):267-271. 10.4046/trd.2015.78.3.267.

Intrathoracic Desmoid Tumor Presenting as Multiple Lung Nodules 13 Years after Previous Resection of Abdominal Wall Desmoid Tumor

• Koo GW
• Chung SJ
• Kwak JH
• Oh CK
• Park DW
• Kwak HJ
• Moon JY
• Kim SH
• Sohn JW
• Yoon HJ
• Shin DH
• Park SS
• Oh YH
• Pyo JY
• Kim TH

• KMID: 2320654
• DOI: http://doi.org/10.4046/trd.2015.78.3.267

Abstract

Desmoid tumors are rare soft tissue tumors considered to have locally infiltrative features without distant metastasis until now. Although they are most commonly intraabdominal, very few cases have extra-abdominal locations. The origin of intrathoracic desmoid tumors is predominantly the chest wall with occasional involvement of pleura. True intrathoracic primary desmoid tumors with no involvement of the chest wall or pleura are extremely rare. We recently experienced a case of true intrathoracic desmoid tumor presenting as multiple lung nodules at 13 years after resection of a previous intraabdominal desmoid tumor.

Keyword

Fibromatosis, Aggressive; Thorax; Multiple Pulmonary Nodules

MeSH Terms

Abdominal Wall*
Fibromatosis, Aggressive*
Lung*
Multiple Pulmonary Nodules
Neoplasm Metastasis
Pleura
Thoracic Wall
Thorax

Figure

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  Figure 1 Chest X-ray showing multiple lung nodules with multifocal haziness in the right lung.

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  Figure 2 (A-D) Chest computed tomography scan demonstrating well circumscribed, multiple nodules and multiple ill defined ground glass opacity nodules in both lungs.

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  Figure 3 Histologic findings of biopsy. (A) Lung biopsy revealing spindle-shaped myo- fibroblast proliferation within collagenized and myxoid background (H&E stain, ×200). (B) Spindle cells stained with vimentin (×200). (C) Negative for CD34 (×100). (D) The intra-abdominal mass with the same histology as lung biopsy (H&E stain, ×200).

Reference

1. Dalen BP, Bergh PM, Gunterberg BU. Desmoid tumors: a clinical review of 30 patients with more than 20 years' follow-up. Acta Orthop Scand. 2003; 74:455–459.

2. McKinnon JG, Neifeld JP, Kay S, Parker GA, Foster WC, Lawrence W Jr. Management of desmoid tumors. Surg Gynecol Obstet. 1989; 169:104–106.

3. Posner MC, Shiu MH, Newsome JL, Hajdu SI, Gaynor JJ, Brennan MF. The desmoid tumor. Not a benign disease. Arch Surg. 1989; 124:191–196.

4. Skene AI, Barr L, A'Hern RP, Fisher C, Meirion Thomas J. Multimodality treatment in the control of deep musculoaponeurotic fibromatosis. Br J Surg. 1998; 85:655–658.

5. Bolke E, Krasniqi H, Lammering G, Engers R, Matuschek C, Gripp S, et al. Chest wall and intrathoracic desmoid tumors: surgical experience and review of the literature. Eur J Med Res. 2009; 14:240–243.

6. Andino L, Cagle PT, Murer B, Lu L, Popper HH, Galateau-Salle F, et al. Pleuropulmonary desmoid tumors: immunohistochemical comparison with solitary fibrous tumors and assessment of beta-catenin and cyclin D1 expression. Arch Pathol Lab Med. 2006; 130:1503–1509.

7. Kim NR, Chung DH, Lee JI, Jeong SH, Ha SY. Intrathoracic desmoid tumor mimicking pleural mass: a case report. Tuberc Respir Dis. 2009; 67:449–453.

8. Schwickerath J, Kunzig HJ. Spontaneous malignant transformation of extra-abdominal fibromatosis to fibrosarcoma. Geburtshilfe Frauenheilkd. 1995; 55:173–175.

9. Shields CJ, Winter DC, Kirwan WO, Redmond HP. Desmoid tumours. Eur J Surg Oncol. 2001; 27:701–706.

10. Iqbal M, Rossoff LJ, Kahn L, Lackner RP. Intrathoracic desmoid tumor mimicking primary lung neoplasm. Ann Thorac Surg. 2001; 71:1698–1700.

11. Varghese TK Jr, Gupta R, Yeldandi AV, Sundaresan SR. Desmoid tumor of the chest wall with pleural involvement. Ann Thorac Surg. 2003; 76:937–939.

12. Tejpar S, Nollet F, Li C, Wunder JS, Michils G, dal Cin P, et al. Predominance of beta-catenin mutations and beta-catenin dysregulation in sporadic aggressive fibromatosis (desmoid tumor). Oncogene. 1999; 18:6615–6620.

13. Wilcken N, Tattersall MH. Endocrine therapy for desmoid tumors. Cancer. 1991; 68:1384–1388.

14. Briand S, Barbier O, Biau D, Bertrand-Vasseur A, Larousserie F, Anract P, et al. Wait-and-see policy as a first-line management for extra-abdominal desmoid tumors. J Bone Joint Surg Am. 2014; 96:631–638.

15. Aggarwal D, Dalal U, Mohapatra PR, Singhal N. Intra-thoracic desmoid tumor. Lung India. 2012; 29:160–162.