Posters— Surgical Treatment of Sarcomas

DESMOPLASTIC FIBROMA: EXPERIENCE OF THE ISTITUTO ORTOPEDICO RIZZOLI

Fabbri N., Trentani F., Vanel D., Mercuri M., Picci P., Bertoni F. Department of Musculoskeletal Oncology, Istituto Ortopedico Rizzoli – Bologna, Italy

Desmoplastic fibroma is a rare benign tumor of bone. Despite its benign nature a marked tendency for local recurrence has been reported in the past. However, studies reporting series of patients homogeneously managed at the same Institution are scant in the recent literature.

From 24855 bone tumors filed at our Institution, 16 cases of desmoplastic fibroma were identified. A retrospective study of this group of patients was undertaken; clinico- pathologic features were reviewed and analyzed along with follow-up in order to define biologic aggressiveness and potential for local recurrence of this disorder.

There were 9 males and 7 females, average age was 22 years (9-36). Swelling and pain usually lasting more than 6 months were the most common presenting symptoms. Tumor location was the femur in 5 cases (3 proximal, 2 distal), tibia in 3 cases (2 proximal, 1 distal), humerus in 2 cases (1 proximal, 1 shaft), fibula in 2 cases (1 proximal, 1 distal), calcaneus, periacetabular region, sacrum and L2 body one case each.

Imaging studies constantly showed a purely lytic defect, sharply marginated towards the bone and contained by paper thin cortex towards the surrounding soft tissues. Staging of the tumor according to MSTS was stage 2 in 12 cases, stage 3 in 3 cases, and stage 1 in one case.

Information regarding the surgical margin and a minimum follow-up longer than 3 years were available in 14 patients (average 5 years, range 3-22). Surgical management consisted of wide resection in 9 cases and intralesional curettage in 5 cases; in 3 cases the use of phenol or liquid nitrogen was added to the curettage as a local adjuvant.

All the patients were disease free. None of the patients developed metastasis. In our experience prognosis is excellent after adequate surgical management, either wide resection or aggressive curettage.