Desmoide della parete toracica, ad insorgenza postchirurgica


Antonio Fimmanò, Enrico Coppola Bottazzi, Claudia Cirillo, Pasquale Tammaro, Dino Casazza

Ann. Ital. Chir., 2006; 77: 169-172

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AIM OF THE STUDY: The Authors report on a patient personally observed owing to a tumefaction, mimicking a pomelo,
located on the posterior chest wall, in the same site of another past surgical operation dating back to four years ago.
This tumefaction was clear at the inspection, not aching and hard-elastic at the palpation, mobile synchronously with
respiratory movements, but unable to alter respiratory mechanics.
CASE REPORT: The patient was subjected to laboratory tests, which showed nothing pathological, and to instrumental tests
(RX and TAC of the chest, bony scintigraphy) which showed a roundish solid tumefaction, with no “secondary” interest
of bony tissue. In this case, it was executed a posterior-lateral thoracothomy, at the VI intercostal space, in the area
circumscribing the past surgical scar.
The careful removal of the adhesions between the mass and the costal plane, not without the sacrifice of the periosteum,
permitted us the total exeresis.
The anatomo-pathological test showed a desmoid fibromatosis (desmoid tumor) extra-abdominal (12.5 x 9 x 5 cm).
About this kind of neoplastic masses, the risk of post-surgical relapse is very high; so many Authors consider opportune
a radio-chemical adjuvant therapy.
In this case, the radical excision allowed the Authors to avoid the post surgery pharmacological treatment and to get no
relapses after two years from the operation.