Purpose: Desmoid tumors (aggressive fibromatosis) are locally aggressive lesions associated with substantial morbidity and mortality due to invasion of adjacent neurovascular structures and vital organs. The disease is unpredictable and enigmatic. While 5-15% of cases are seen in patients with Familial Adenomatous Polyposis (FAP) syndrome, the vast majority arise sporadically. The etiology of desmoids remains poorly understood and the therapeutic approaches in their management remain diverse. Surgical resection is curative in less than 50% of cases and residual recurrence tends to be increasingly aggressive and infiltrative. We evaluated the efficacy of intra-arterial doxorubicin eluting bead embolization for extra-abdominal desmoid fibromas.
Materials & Methods: Three patients aged 6–16 years underwent between 2-4 sequential treatments of Doxorubicin-eluting microspheres (100um-300um) at doses of 50-100 mg per treatment. All treatments were performed using super-selective angiographic technique.
Results: Tumor volumes were reduced by greater than 90% in all cases. There were no clinically significant adverse treatment effects, with the exception of transient lower extremity neuropathy in one patient.
Conclusion: These are the first cases of selective arterial chemo-embolization for desmoid fibromas described in the English literature; our results suggest a safe and effective new treatment option for non-operable candidates or as a neo-adjuvant option.
