Juvenile fibromatosis of the infratemporal fossa

Isolated Infratemporal Fossa Desmoid Fibromatosis: A Rare Case Report and Review of Literature

Desmoid fibromatosis (DF) arising from musculoaponeurotic structures rarely affects the head and neck region with the abdomen being the most common site of origin. These are benign tumors with locally infiltrative nature usually presenting as painless swellings that are rapidly growing. The infratemporal fossa DF is an extremely rare location with few clinical reports. This article discusses the management of a 2-year-old child with DF of the infratemporal fossa (ITF) along with literature review.

Desmoid tumors in neurosurgery: a review of the literature

Desmoid tumors (DTs) are rare myofibroblastic neoplasms, which are mostly sporadic, but sometimes associated with familial adenomatous polyposis syndrome. Neurosurgical cases of DT have been very scarce. We review the literature concerning neurosurgical DTs and describe the first case of a cicatricial DT after the resection of vestibular schwannoma, presenting as a painful swelling in the retrosigmoid scar. Contrary to other localizations in the body, standard-of-care wide margin resection cannot be performed in intracranial and spinal DTs. Therefore, maximally safe resection followed by radiotherapy when tumor margins are not free can be proposed as a treatment strategy in neurosurgical DTs.

Infantile intracranial aggressive fibromatosis: report of two cases with a review of the literature

Aggressive fibromatosis (AF) is characterized by a nonmetastatic fibroblastic proliferative lesion that is histologically benign with infiltrative growth and frequent recurrence. To our knowledge, infantile AF is rarely reported. There are no clear guidelines regarding the management and treatment strategies for intracranial infantile AF because of its rarity. In China, there are few reports in the clinical literature concerning intracranial infantile AF. We describe 2 cases of intracranial infantile AF and review the relevant literature to better understand the pathological features, differential diagnosis and treatment of this condition.

Extra-abdominal fibromatosis (desmoid tumor) arising in the infratemporal fossa: a case report

Aggressive fibromatosis (or desmoid tumor) refers to a histologically benign but locally aggressive lesion arising from musculoaponeurotic structures in various anatomic sites. Extra-abdominal desmoids represent about one third of all desmoid tumors; of these only about 11 to 15% arise in the head and neck. Desmoid tumors arising in the infratemporal fossa are exceedingly rare; to our knowledge only one such tumor has been reported in the literature. We present a desmoid tumor arising in the infratemporal fossa with intracranial extension in a twenty-seven year old male and review the literature on this rare condition.

Aggressive fibromatosis involving the cranial base in children

OBJECTIVE

Aggressive fibromatoses are proliferations of fibrous tissue that infiltrate surrounding tissues and tend to recur after surgical resection. We report a series of five children with aggressive fibromatosis involving the cranial base.

METHODS

A search of the database maintained by the Medical Informatics Department at The University of Texas M.D. Anderson Cancer Center identified 78 patients with aggressive fibromatosis of the head and neck. Of these patients, five demonstrated involvement of the cranial base. All five were children. A retrospective review of the charts, diagnostic images, and pathological findings for these five patients was performed.

RESULTS

Surgery, radiotherapy, chemotherapy, and hormonal therapy were the treatment methods used. Four patients underwent gross total resections, but tumor cells were present at the margins in all cases. Two of these four patients experienced recurrences; one patient was cured of disease by a second surgical resection and radiotherapy, and the other underwent a second gross total resection. The fifth patient underwent a subtotal resection. He has experienced four recurrences and continues to live with residual disease. One transformation to a Grade 2 fibrosarcoma was observed.

CONCLUSION

Fibromatoses of the cranial base are rare and seem to be most common in the pediatric age group. Gross total resection, preferably in the first attempt, should be the goal. Radiotherapy and hormonal therapy are useful adjunctive methods for the treatment of aggressive fibromatosis. Fibromatoses that involve the cranial base are most likely to require a multidisciplinary treatment approach.

Fibromatosis of the oral and paraoral region

The fibromatoses represent a group of infiltrating fibrous proliferations that exhibit a clinical behavior and biologic potential intermediate between benign fibrous lesions and fibrosarcoma. The head and neck region is a common site of involvement for these lesions especially in children and young adults. However, the oral structures per se are not often the site of origin. In this study of 31 cases of fibromatosis that involved the oral and paraoral region, patient ages ranged from birth to 51 years with 74% appearing in the first decade. The most common clinical presentation was a painless mass that involved the cheek, tongue, or submandibular region. Erosion of bone was a frequent finding in lesions arising in soft tissue contiguous with the jaws. After surgical excision, lesions recurred in five patients for a recurrence rate of 23.8%. One lesion recurred twice. The average interval from initial treatment to recurrence was 7.6 months. The recurrence rate observed in this series is significantly lower than that generally reported for fibromatosis of the head and neck (50% to 70%). This is most likely due to the exclusion in this investigation of lesions in the supraclavicular region.