Fibromatosis : where are we now?

Abstract

PURPOSE OF THE STUDY Fibromatosis is a benign but locally aggressive tumour. A high rate of recurrence was noted in a number of patients treated by the senior author at a tumour and sepsis unit despite the fact that a wide surgical excision had been performed. The question was raised whether there are any alternate treatment modalities with a higher success rate available currently. A retrospective study and review of the literature was performed in order to ascertain whether new treatment modalities which can prevent recurrence more successfully have been developed recently. MATERIALS AND METHODS A retrospective study was performed. The files of all patients who presented at an orthopaedic practice with confirmed fibromatosis on histological examination in the past 19 years were reviewed. The following was looked at: age of the patient at first presentation; gender; tumour site; surgery performed; histological results; first line of treatment and recurrence rate. Patients were also contacted telephonically in order to ascertain whether any recurrence managed by another orthopaedic surgeon had been attended to. RESULTS We evaluated 17 patients of which eight were males and nine females. The mean age was 25.87 years (range 2–52years). All of the primary sites were extra-abdominal. Median follow up was 3.9 years (0–9) with a mean recurrence rate of 2.3 times. All the patients were treated with a wide marginal surgical excision without adjuvant therapy. CONCLUSION Fibromatosis has a high recurrence rate using current surgical treatment modalities. Complete surgical excision does not lead to a good outcome. The literature review revealed that a wide variety of treatment modalities, both surgical and non-surgical, are available. Non-surgical treatment modalities include: hormones; non-steroidal anti-inflammatory drugs; chemotherapy; radiotherapy. Wide surgical excision remains the mainstay of treatment but a multidisciplinary approach is necessary in order to optimise the efficacy of this treatment.