Aggressive fibromatosis of head and neck: Considerations on the optimal treatment method on the basis of case report

• Published in: Polish annals of medicine 2017-02, Vol.24 (1), p.48-51
• Main Authors: Kopala, Wacław, Siniarski, Marcin, Grzybowska, Sylwia, Pietrzak, Maciej, Poniatowska-Broniek, Grażyna, Kukwa, Andrzej
• Format: Article
• Language: English
• Subjects: Aggressive fibromatosis; Chemotherapy; Children; Head and neck; Surgery
• ISSN: 1230-8013
• DOI: 10.1016/j.poamed.2016.05.006

The term fibromatosis refers to proliferation of fibrous tissue in the form of irregular nodules or soft tissue sarcoma. It is characterized by local malignancy with tendency to recurrence, significant hypertrophy of the mature connective tissue and lack of the ability to form distant metastases. Pathological lesions originate from fascial, muscle and tendinous tissue. The aim of this work is to analyze the efficacy and safety of the selected methods of treatment of aggressive fibromatosis on the basis of the presented case. A five-year-old boy was admitted to the Department of Otolaryngology of the Provincial Specialist Children’s Hospital in Olsztyn due to right sided cervical mass. Histological examination of biopsy material revealed aggressive fibromatosis. The child was previously treated for two years with systemic chemotherapy with methotrexate, vinblastine, vincristine, imatinib and tamoxifen with no improvement. Surgical tumor removal was performed on February 14, 2014. During the 18-month observation period no signs of tumor recurrence were observed. In the treatment of aggressive fibromatosis various therapeutic methods are used, including radiotherapy, chemotherapy and surgery. The effects of chemotherapy and radiotherapy are frequently unsatisfying. These methods are associated with numerous complications and side effects, thus mode of treatment should be considered individually for each patient. In case of the presented patient surgical tumor removal was the best and the most effective treatment method. Surgery should be a treatment of choice, whereas chemotherapy and radiotherapy should be considered as alternative or complementary methods in the treatment of aggressive fibromatosis.