Desmoid tumor medical therapy: Difference between revisions

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Case #1

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Revision as of 15:14, 26 January 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Medical therapy for desmoid tumor includes antiestrogens (ex. Tamoxifen), NSAIDs, chemotherapy or microwave ablation.

Medical Therapy

Medical therapy for prolactinoma includes:^[1] Wide surgical resection with clear margins is the most widely practiced technique with radiation, chemotherapy, or hormonal therapy being used to reduce the risk of recurrence.^[2]

Antiestrogens (ex. Tamoxifen)
NSAIDs
Chemotherapy
Microwave ablation

Current experimental studies are being done with Gleevec (Imatinib) and Nexavar (sorafenib) for treatment of desmoid tumors, and show promising success rates.

Radiation Therapy

Rarely, radiation therapy is used if medical therapy and surgery fail. Depending on the size and location of the tumor, radiation is delivered either in low doses over the course of 5 to 6 weeks or in a single high dose. Radiation therapy is effective in approximately 30% of cases.

Reference

↑ Wilkinson MJ, Fitzgerald JE, Thomas JM, Hayes AJ, Strauss DC (2012). "Surgical resection for non-familial adenomatous polyposis-related intra-abdominal fibromatosis". BJS. 99 (5): 706–13. doi:10.1002/bjs.8703. PMID 22359346.
↑ Rammohan A, Wood JJ (2012). "Desmoid tumour of the breast as a manifestation of Gardner's syndrome". Int J Surg Case Rep. 3 (5): 139–42. doi:10.1016/j.ijscr.2012.01.004. PMC 3312056. PMID 22370045.CS1 maint: PMC format (link)

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[pmid22359346-1] Wilkinson MJ, Fitzgerald JE, Thomas JM, Hayes AJ, Strauss DC (2012). "Surgical resection for non-familial adenomatous polyposis-related intra-abdominal fibromatosis". BJS. 99 (5): 706–13. doi:10.1002/bjs.8703. PMID 22359346.

[pmid22370045-2] Rammohan A, Wood JJ (2012). "Desmoid tumour of the breast as a manifestation of Gardner's syndrome". Int J Surg Case Rep. 3 (5): 139–42. doi:10.1016/j.ijscr.2012.01.004. PMC 3312056. PMID 22370045.CS1 maint: PMC format (link)

[1]

[2]

@@ Line 3: / Line 3: @@
 {{CMG}} {{AE}}{{Faizan}}
 ==Overview==
+Medical therapy for desmoid tumor includes [[antiestrogen]]s (ex. [[Tamoxifen]]), [[non-steroidal anti-inflammatory drug|NSAIDs]], [[chemotherapy]] or microwave ablation.
 ==Medical Therapy==
-Treatment may consist of watching and waiting, complete [[surgery|surgical]] removal, [[radiation therapy]], [[antiestrogen]]s (ex. [[Tamoxifen]]), [[non-steroidal anti-inflammatory drug|NSAIDs]], [[chemotherapy]] or microwave ablation.
+Medical therapy for prolactinoma includes:<ref name="pmid22359346">{{cite journal |author=Wilkinson MJ, Fitzgerald JE, Thomas JM, Hayes AJ, Strauss DC|title=Surgical resection for non-familial adenomatous polyposis-related intra-abdominal fibromatosis |journal=BJS. |volume=99 |issue=5 |pages=706–13|year=2012 |doi=10.1002/bjs.8703 |pmid=22359346}}</ref> Wide surgical resection with clear margins is the most widely practiced technique with radiation, chemotherapy, or hormonal therapy being used to reduce the risk of recurrence.<ref name="pmid22370045">{{cite journal| author=Rammohan A, Wood JJ| title=Desmoid tumour of the breast as a manifestation of Gardner's syndrome. | journal=Int J Surg Case Rep | year= 2012 | volume= 3 | issue= 5 | pages= 139-42 | pmid=22370045 | doi=10.1016/j.ijscr.2012.01.004 | pmc=PMC3312056 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22370045  }} </ref>
+*[[Antiestrogen]]s (ex. [[Tamoxifen]])
+*[[Non-steroidal anti-inflammatory drug|NSAIDs]]
+*[[Chemotherapy]]
+*Microwave ablation
-Patients with desmoid tumors should be evaluated by a multi-disciplinary team of surgeons, medical oncologists, radiation oncologists, geneticists and nurses.  There is no cure for desmoid tumors and when possible patients are encouraged to enlist in clinical trials. <ref>http://www.dtrf.org/index.php/about-br-desmoid-tumors/about-desmoid-tumors.html</ref>
+Current experimental studies are being done with Gleevec ([[Imatinib]]) and Nexavar ([[sorafenib]]) for treatment of desmoid tumors, and show promising success rates.
-A biopsy is always indicated as the deﬁnitive method to determine nature of the tumour. Management of these lesions is complex, the main problem being the high rates of recurrence in FAP associated disease. Conversely, for intra-abdominal fibromatosis without evidence of FAP, although extensive surgery may still be required for local symptoms, the risk of recurrence appears to be lower.<ref name="pmid22359346">{{cite journal |author=Wilkinson MJ, Fitzgerald JE, Thomas JM, Hayes AJ, Strauss DC|title=Surgical resection for non-familial adenomatous polyposis-related intra-abdominal fibromatosis |journal=BJS. |volume=99 |issue=5 |pages=706–13|year=2012 |doi=10.1002/bjs.8703 |pmid=22359346}}</ref> Wide surgical resection with clear margins is the most widely practiced technique with radiation, chemotherapy, or hormonal therapy being used to reduce the risk of recurrence.<ref name="pmid22370045">{{cite journal| author=Rammohan A, Wood JJ| title=Desmoid tumour of the breast as a manifestation of Gardner's syndrome. | journal=Int J Surg Case Rep | year= 2012 | volume= 3 | issue= 5 | pages= 139-42 | pmid=22370045 | doi=10.1016/j.ijscr.2012.01.004 | pmc=PMC3312056 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22370045  }} </ref>
+==Radiation Therapy==
+Rarely, [[radiation therapy]] is used if medical therapy and [[surgery]] fail.  Depending on the size and location of the [[tumor]], [[radiation]] is delivered either in low doses  over the course of 5 to 6 weeks or in a single high dose. [[Radiation]] therapy is effective in approximately 30% of cases.
-Current experimental studies are being done with Gleevec ([[Imatinib]]) and Nexavar ([[sorafenib]]) for treatment of desmoid tumors, and show promising success rates.