Abstract
Aggressive fibromatosis is a locally invasive tumor that does not metastasize. Only few cases of scapulectomy for fibromatosis of scapular muscles are reported in the world literature. We present two consecutive cases of scapulectomy done for fibromatosis of periscapular muscles at the Department of Surgical Oncology in our centre between 2014 and 2019. One patient underwent subtotal scapulectomy by posterior approach and the other patient underwent scapulectomy below spine of scapula by combined anterior and posterior approach. The follow-up period of both the patients was 5 years. One patient developed recurrence after 9 months of surgery dealt by re-resection followed by adjuvant radiation. The modified Musculoskeletal Tumor Society (MSTS) score for scapular surgery was 20 in the first patient and 22 in the second patient. Both of them are able to carry out normal regular activities with the compensation from the opposite upper limb. Scapulectomy for symptomatic fibromatosis of the scapular muscles gives acceptable functional results and good disease-free interval. Scapulectomy should be considered as part of resection for better tumor clearance in fibromatosis involving muscles around the scapula. Further studies are needed to evaluate and validate the need for radical surgery in this setting.
Full text article
References
Bhaskar, A. R., Dhir, R. S., Desai, M., Mistry, A. A. 1994. Large myofascial fibromatosis involving the shoulder girdle. Journal of Postgraduate Medicine, 40(4):225–227.
Camargo, V. P. D., Keohan, M. L., Adamo, D. R., Antonescu, C. R., Brennan, M. F., Singer, S., Ahn, S., Maki, R. G. 2010. Clinical outcomes of systemic therapy for patients with deep fibromatosis (desmoid tumor). Cancer, 116(9):2258–2265.
Chew, C., Reid, R., Dwyer, P. J. 2004. Evaluation of the long term outcome of patients with extremity desmoids. European Journal of Surgical Oncology (EJSO), 30(4):428–432.
Fiore, M., Macneill, A., Gronchi, A., Colombo, C. 2016. Desmoid-Type Fibromatosis: Evolving Treatment Standards. Surgical Oncology Clinics of North America, 25(4):803–826.
Fiore, M., Rimareix, F., Mariani, L., Domont, J., Collini, P., Péchoux, C. L., Casali, P. G., Cesne, A. L., Gronchi, A., Bonvalot, S. 2009. Desmoid-Type Fibromatosis: A Front-Line Conservative Approach to Select Patients for Surgical Treatment. Annals of Surgical Oncology, 16(9):2587–2593.
Foà, R., Rizzo, S., Petrella, F., De Maria, F., Bellomi, 2014. Recurrent aggressive fibromatosis of the chest wall. ecancermedicalscience, 8:464.
Gibbons, C. L. M. H., Bell, R. S., Wunder, J. S., Griffin, A. M., Sullivan, B., Catton, C. N., Davis, A. M. 1998. Function after subtotal scapulectomy for neoplasm of bone and soft tissue. The Journal of Bone and Joint Surgery, 80(1):38–42.
Goldblum, J. R., Fletcher, J. A. 2013. Desmoid-type fibromatosis. In: Fletcher DM, Bridge JA, Hogendoorn P, Mertens F, WHO Classification of Tumors of Soft Tissue and Bone, 4th ed. Lyon: IARC;72-73. ISBN: 978-92-832-2434-1.
Hajjar, W. M., Alshehri, A. F., Alessa, M. A., Al-Nassar, S. A. 2017. Late Presentation of Aggressive Fibromatosis Involving Head, Neck and Chest Wall. Journal of the College of Physicians and Surgeons–Pakistan, 27(10):654–656.
Hayashi, K., Iwata, S., Ogose, A., Kawai, A., Ueda, T., Otsuka, T., Tsuchiya, H. 2014. Factors that Influence Functional Outcome after Total or Subtotal Scapulectomy: Japanese Musculoskeletal Oncology Group (JMOG) Study. . PLoS ONE, 9(6):e100119.
Karabulut, S., Keskin, S., Ekenel, M., Basaran, M., Agaoglu, F., Ozger, H., Bavbek, S. 2013. The clinical effect of a positive surgical margin and adjuvant postoperative radiotherapy in the treatment of resectable desmoid tumors. Molecular and Clinical Oncology, 1(6):1061–1064.
Kiss, J., Sztrinkai, G., Antal, I., Kiss, J., Szendrői, M. 2007. Functional results and quality of life after shoulder girdle resections in musculoskeletal tumors. Journal of Shoulder and Elbow Surgery, 16(3):273–279.
Kotiligam, D., Lazar, A. J. F., Pollock, R. E., Lev, D. 2008. Desmoid tumor: a disease opportune for molecular insights. Histology and Histopathology, 23(1):117–126.
Lee, S. H., Lee, H. K., Song, J. S., Jeong, H. S. 2012. Chest Wall Fibromatosis in the Axilla. Archives of Plastic Surgery, 39(2):175–177.
Lev, D., Kotilingam, D., Wei, C., Ballo, M. T., Zagars, K., Pisters, P. W. T., Lazar, A. A., Patel, S. R., Benjamin, R. S., Pollock, R. E. 2007. Optimizing Treatment of Desmoid Tumors. Journal of Clinical Oncology, 25(13):1785–1791.
Malawer, M. M. 1991. Tumors of the shoulder girdle: technique of resection and description of a surgical classification. Orthopedic Clinics of North America, 22(1):7–35.
Muller, E., Castagnaro, M., Yandel, D. W., Wolfe, G. J., Alman, B. A. 1996. Molecular Genetic and Immunohistochemical Analysis of the Tumor Suppressor Genes Rb and p53 in Palmar and Aggressive Fibromatosis. Diagnostic Molecular Pathology, 5(3):194–200.
Öztürk, R., Arıkan, Ş. M., Toğral, G., Güngör, B. Ş. 2019. Malignant tumors of the shoulder girdle: Surgical and functional outcomes. Journal of Orthopaedic Surgery, 27(2).
Salas, S., Dufresne, A., Bui, B., Blay, J. Y., Terrier, P., Ranchere-Vince, D., Bonvalot, S., Stoeckle, E., Guillou, L., Cesne, A. L., Oberlin, O., Brouste, V., Coindre, J. M. 2011. Prognostic Factors Influencing Progression-Free Survival Determined from a Series of Sporadic Desmoid Tumors: A Wait-and-See Policy According to Tumor Presentation. Journal of Clinical Oncology, 29(26):3553–3558.
Santti, K., Beule, A., Tuomikoski, L., Rönty, M., Jääskeläinen, A. S., Saarilahti, K., Blomqvist, C. 2017. Radiotherapy in desmoid tumors. Strahlentherapie und Onkologie, 193(4):269–275.
Trufero, J. M., Bernad, I. P., Ramón, I. T., Cubero, J. H., Cid, R. P. 2017. Desmoid-Type Fibromatosis: Who, When, and How to Treat. Current Treatment Options in Oncology, 18(5):29.
Vahanan, N. M., Mohanlal, P., Bose, J. C., Gangadharan, R., Karthisundar, V. 2007. The functional and oncological results after scapulectomy for scapular tumours: 2-16-year results. International Orthopaedics, 31(6):831–836.
Veth, R., Hoesel, R. V., Pruszczynski, M., Hoogenhout, J., Schreuder, B., Wobbes, T. 2003. Limb salvage in musculoskeletal oncology. The Lancet Oncology, 4(6):343–350.
Vitale, K. C., Jimenez, A. 2009. Rehabilitation After Scapulectomy. American Journal of Physical Medicine and Rehabilitation, 88(4):267–271.
Walker, E. A., Petscavage, J. M., Brian, P. L., Logie, C. I., Montini, K. M., Murphey, M. D. 2012. Imaging Features of Superficial and Deep Fibromatoses in the Adult Population. Sarcoma, pages 1–17.
Wood, T. J., Quinn, K. M., Farrokhyar, F., Deheshi, B., Corbett, T., Ghert, M. A. 2013. Local control of extra-abdominal desmoid tumors: systematic review and meta-analysis. Rare Tumors, 5(1):5–10.
Yao, X., Corbett, T., Gupta, A. A., Kandel, R. A., Verma, S., Werier, J., Ghert, M. 2014. A Systematic Review of Active Treatment Options in Patients with Desmoid Tumours. Current Oncology, 21(4):613–629.
Authors
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.