Desmoid Tumors of the Upper Extremity

PurposeTo determine the outcomes of surgical excision with or without adjuvant treatment in the management of desmoid tumors of the upper extremity.MethodsWe retrospectively reviewed 52 patients with a histologically confirmed desmoid tumor in the upper extremity that was managed surgically. All patients presented between 1970 and 2011 and had a minimum 2-year follow-up.ResultsThere were 25 males and 27 females with an average age of 37 ± 17 years. The most common location was the shoulder (n = 27). The most common symptom was a painful mass (n = 30). Average tumor size was 189 ± 371 cm3. Negative margins (wide or marginal resection) were achieved in 43 patients. The 5-year disease-free interval was 57%. Patients with recurrence were younger than those without (31 vs 43 y). Postoperative radiotherapy increased the time to recurrence (2.6 vs 1.6 y) but ultimate disease-free interval at 5 years was similar in patients who did and did not receive radiotherapy. Compared with the preoperative evaluation, there was a significant reduction in patients reporting moderate or severe pain postoperatively.ConclusionsDesmoid tumors are locally aggressive fibrous tumors. Recurrence after surgical excision of a desmoid tumor in the upper extremity is common, especially in younger patients. Adjuvant radiation therapy tended to increase time to recurrence but not rate of recurrence.Type of study/level of evidenceTherapeutic IV.