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  • Surgical Aspects of Paraspinal Desmoid Tumors

    Final Number:
    1283

    Authors:
    Anthony Michael Burrows MD; Mohammed Abdulaziz; Ma Khin Pyi Son BS; Michael J. Link MD; Robert J. Spinner MD; Michelle J. Clarke MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Desmoid tumors are benign but locally invasive tumors that are associated with Gardner’s syndrome (FAP). Risk factors include surgery, but reports of this tumor following spine surgery remain uncommon.

    Methods: A retrospective review of all neurosurgical cases at a single tertiary referral center was performed. All cases of paraspinal desmoid tumors from 2000-2011 were identified and pertinent demographic and medical data was recorded from the patients’ medical records

    Results: Six cases of paraspinal desmoid tumors were identified. Three patients developed postoperative desmoid tumors following posterior cervical laminectomies and 3 presented with posterior cervical paraspinal masses. Three had FAP mutations, 1 in the post laminectomy group and 2 in the group presenting with neck masses. All patients underwent resection; only one had negative surgical margins. Additional surgical teams were needed in 5 cases, including otolaryngology for radical neck dissections, and plastic surgery for myocutaneous flap advancements. Adjuvant fractionated radiotherapy was utilized in 5 cases and the same 5 patients also required multiple adjuvant chemotherapy regimens. Mean follow up was 77 months. Two patients died from their disease at a mean of 59 months after presentation. Three patients had stable radiographic recurrence. Three patients had wound complications, with 2 dehiscences of rotational flaps and a deep wound infection. Two patients developed kyphotic deformity (at 14 and 18 months) requiring surgical correction with multilevel constructs.

    Conclusions: Treatment of Desmoid tumors may require multidisciplinary care. Desmoid tumors recur frequently and require adjuvant chemotherapy and radiotherapy that may lead to high rates of wound complications. Excision of muscle mass from cervical spine may predispose to kyphotic deformity.

    Patient Care: By improving the quality of spinal desmoid tumor treatment

    Learning Objectives: At the end of the session, participants should be able to: 1)Describe the complications seen following desmoid tumor resection 2)Describe the risk factors for developing desmoid tumors 3)Describe the necessary support needed to help treat desmoid tumors

    References:

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