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Desmoid tumours:
Desmoid tumors are troublesome in about 10% of patients with
FAP
. They may be lethal in 10% of those affected. There is an
association with particular APC
mutations. It is apparantly
necessary for both alleles of the APC
gene to be knocked out in
desmoids. They are are aggrevated by trauma and oestrogen.
From the management point of view desmoids can be divided into
those in the abominal wall and those that are intra-abdominal.
Resection is advised for abdominal wall desmoids but it is
recommended to avoid surgery for intra-abdominal desmoids as this
may be lethal and usually aggravates the desmoid rather than
curing it.
Of interest, desmoids may respond to NSAID and anti-oestrogen drug
therapy.
Adrian P. Ireland