Combined Therapy of Surgical Excision and Radiotherapy for Aggressive Fibromatosis - Preliminary Report -

Abstract

Aggressive fibromatosis is an aggressive, benign soft tissue tumor with proliferative fibroblast which is infiltrating into the surrounding musculoaponeurotic compartments. Aggressive fibromatosis has a distinct tendency to local recurrence, even after the proper surgical management, however, it never metastasizes to the lung. After incomplete resection of the tumor mass which has no pseudocapsulation, some recommend a postoperative adjuvant therapy, including radiothreapy and chemotherapy estrogen receptor antagonist. To study the results of the surgical excison, we have compared the preoperative margin at the time of operation by MRI and the presumptive margin by the surgeon with the pathological margin by the pathologist. MRI revealed poor margination in 5 cases and good margination partially in 2 cases. The authors had planned intraoperatively wide marginal resection in 1 case and marginal margin resection in 6 cases. However, we could have obtained marginal margin in 5 cases and intralesional margin in 2 cases. We have managed 7 cases with incomplete excision out of total 22 patients with adjuvant radiotherapy, including either interstitial radiotherapy and external beam radiotherapy. There is no recurrence at average 24.6 months follow up after operation, except one case which recurred at 34 months after operation.