P3.04-040 A Rare Case of Intrathoracic Mass: Intrathoracic Desmoid Tumor: Topic: Miscellaneous II

Abstract

Desmoid tumor is a rare type of tumor which originates from abdominal fascial and musculo-aponeurotic structure. It generally occurs in the abdomen, but rarely may be derived from the chest wall. Pain is the main complaint of the patients admitted to hospital. In this study, we retrospectively evaluated the pre-surgical diagnostic methods, surgical intervention and post-operative follow-up processes and outcomes of a patient who admitted to hospital with a complaint of back pain and were operated in our hospital with the diagnosis of desmoid tumor. 57-year-old male patient was admitted to our clinic with that complaints of left arm and back pain suffered approximately more than 1 year. Due to the increasing pain and ptosis in the left eye, imaging studies were performed and a mass was detected in the left hemithorax. Needle biopsy was applied to the patient two times but no results were obtained. Whereupon, the patient was referred to our clinic. During the physical examination of the patient in our clinic, a mild ptosis in his left eye, palpable and hard fixed mass in the left supraclavicular fossa and loss of breath sounds in the upper left side of the hemithorax were detected. Thorax computed tomography imagination showed an extrapleural mass, 17×13×12 cm in size, which fills the superior and posterior mediastinum with the plexus. Additionally, a mass, 154×114×114 mm in size was reported with SUV upper value of 4.85, consisting with malignancy in the PET-computed tomography. Upon this, posterolateral thoracotomy surgery was applied to the patient and the mass was removed en bloc. The mass was reported as a desmoid tumor based on the pathological findings and the patient was discharged on the postoperative day 6. In the 3rd month of follow-up process, 54 Gy / 30 fr radiotherapy was applied to the left hemitorax apical tumor location. In the control imaging studies following 3., 8., 24. and 30. months of the surgery, no lesion compatible with the recurrence was detected. Desmoid tumor is a rare type of tumor originating from abdominal fascial and musculo-aponeurotic structure. Surgical resection is needed. Because of the possibility of recurrence, surgical intervention should be modified in a way to remain the quality of patient's life.