Desmoid Tumor of the Breast in Young Women: 2 Case Reports

Abstract

INTRODUCTION: Aggressive fibromatosis or desmoid tumors consist of infiltrative proliferations of fibroblastic and myofibroblastic cells, accounting for less than 0. 2% of breast tumors. These tumors are characterized by a locally aggressive growth pattern with frequent recurrences but are non-metastasizing. The ethiology is unknown however there is a well documented association with genetic disorders such as Gardner s syndrome. REPORTING: The authors report two cases of desmoid tumor in young women, one of them bilateral. The first case presented in a 23 year old woman, with a 3 month history of painful palpable mass with rapid growth in the upper external quadrant of the right breast associated with skin retraction. The mammogram and ultrasound show in the right breast two images suggesting a carcinoma and in left breast another image BI-RADS 5. Core biopsies were performed, the right breast suggested a desmoid tumor, but the left one was informed as normal tissue. To establish the diagnosis an excisional biopsy in both breasts was performed. The second case consists of a 22 year old woman, who presented with a rapidly growing breast mass with a presumptive diagnosis of phylloides tumor. A lumpectomy was performed with an attempt of free margins however macroscopically it was difficult to distinguish between the tumor and the normal breast tissue. Delayed biopsy informed a desmoid tumor. Both patients were treated with mastectomy followed by immediate breast reconstruction with expansors. The second one completed her reconstruction with implants, contralateral symmetrization and nipple areola complex reconstruction. DISCUSSION: Even though this tumor has no metastatic potential, wide excision is required because of the higher risk of local recurrence when it is incompletely excised. The role of radiotherapy and of medical treatments such as antioestrogens remains unclear. Desmoid tumors should be considered in the differential diagnosis of a rapid growth tumor in young women, in this way local treatment can be achieved with better oncologic and cosmetic results.