Cic edizioni internazionali
Il Giornale di Chirurgia

Fibromatosi della parete toracica e mammaria.
Casi clinici a confronto

Articolo, 22 - 25
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Introduction: Desmoids of the chest wall are benign and rare tumors that usually arise from the fascia of the pectoralis major muscle, uncommonly from the mammary gland. These tumors sometimes can be locally aggressive, infiltrating surrounding tissues. Clinically they can appear suspicious for malignancy, as palpable and firm masses infiltrating the pectoral muscles.
Case reports: We report the cases of a two young women with an extra-abdominal desmoid. The first case is a pectoralis major desmoids; the patient underwent a wide excision with clear margins and after a follow-up of 12 months is disease free. The second case is about a desmoid arising from the mammary gland. This patient had a wide mammary resection, but one mammary margin was closed; in consideration of the need of a more aggressive surgery in front of a benign disease, the patient refused a further treatment with knowledge of the risk of recurrence.
Discussion: The desmoid tumors are rare and benign diseases that can present serious problems in the differential diagnosis with malignant diseases. In the management of these tumors surgery has a key role with the goal to obtain a good local control through a wide excision with clear margins, avoiding, when it’s possible, aggressive procedures.
Conclusions: Management of desmoid tumors sometimes is difficult and may take in consideration the need of an aggressive surgery in front of a benign disease. A radical excision with a good cosmetic result must be the goal of each surgeon.

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