Intra-lesional NSAIDs Injection: Unreported Treatment in (Extra-abdominal) Desmoid Tumors.

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Wuttipong Siriwittayakorn, MD
Olarn Apornchayanon, MD
Sratwadee Lorsomradee, MD
Nipon Theera-Umpon, PhD
Jongkolnee Settakorn, MD
Dumnoensun Pruksakorn, MD


Desmoid tumors are a rare benign tumor that can be locally aggressive and causemorbidity to a patient. The best way of treatment, whether surgical or non-surgical, hasyet to be found. We report an unreported method of treatment in (extra-abdominal)desmoid tumor which showed a positive result. Our patient presented with (extraabdominal)desmoid tumor on her left forearm that caused her pain and paresthesia inthe left forearm. The mass was located near an important neurovascular structure makingthe authors opt for conservative management. Desmoid tumor cells show expressionof COX-2 and beta-catenin. NSAIDs the COX enzyme inhibitors are used orally toconservatively treat (extra-abdominal) desmoid tumor. To our knowledge, NSAIDshave never been used locally. Here we report our treatment of (extra-abdominal)desmoid tumor by injecting NSAIDs directly into the tumor and follow up on theclinical and radiographic study of the patient. This diversion of treatment, which hadnever been done before, showed a positive outcome in decreasing symptoms and sizeof the tumor in our patient. In this reported case, local NSAIDs injection into (extraabdominal)desmoid tumor showed a positive result. We hope this case report can leadto a further study of this way of treatment and we hope that this report could be a pathto a further study for the cure of desmoid tumors.


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Siriwittayakorn W, Apornchayanon O, Lorsomradee S, Theera-Umpon N, Settakorn J, Pruksakorn D. Intra-lesional NSAIDs Injection: Unreported Treatment in (Extra-abdominal) Desmoid Tumors. BKK Med J [Internet]. 2016Sep.20 [cited 2020Jul.15];12(1):62. Available from:
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1. Papagelopoulos PJ, Mavrogenis AF, Mitsiokapa EA, et al. Current trends in the management of extra-abdominal desmoid tumours. World J Surg Oncol 2006;4:21.
2. Molloy AP, Hutchinson B, O’Toole GC. Extra-abdom- inal desmoid tumours: a review of the literature. Sarcoma 2012;2012:578052.
3. Shido Y, Nishida Y, Nakashima H, et al. Surgical treatment for local control of extremity and trunk desmoid tumors. Arch Orthop Trauma Surg 2009;129(7):929-33.
4. Escobar C, Munker R, Thomas JO, et al. Update on desmoid tumors. Ann Oncol 2012;23(3):562-9.
5. Melis M, Zager JS, Sondak VK. Multimodality manage- ment of desmoid tumors: how important is a negative surgical margin? J Surg Oncol 2008;98(8):594-602.
6. Walczak BE, Rose PS. Desmoid: the role of local therapy in an era of systemic options. Curr Treat Options Oncol 2013;14(3):465-73
7. von Mehren M, Randall RL, Benjamin RS, et al. Soft tissue sarcoma, version 2.2014. J Natl Compr Canc Netw 2014;12(4):473-83.
8. Devata S, Chugh R. Desmoid tumors: a comprehensive review of the evolving biology, unpredictable behavior, and myriad of management options. Hematol Oncol Clin North Am 2013;27(5):989-1005.
9. Goldblum J, Fletcher J. Desmoid-type fibromatoses. World Health Organisation Classification of Tumours: Pathology and Genetics of Tumours of Soft Tissue and Bone. 2002:83-4.
10. Hamada S, Urakawa H, Kozawa E, et al. Nuclear expression of β-catenin predicts the efficacy of meloxicam treatment for patients with sporadic desmoid tumors. Tumour Biol 2014;35(5):4561-6.
11. Nishida Y, Tsukushi S, Shido Y, et al. Successful treat- ment with meloxicam, a cyclooxygenase-2 inhibitor, of patients with extra-abdominal desmoid tumors: a pilot study. J Clin Oncol 2010;28(6):e107-9.
12. Tanaka K, Yoshikawa R, Yanagi H, et al. Regression of sporadic intra-abdominal desmoid tumour following administration of non-steroidal anti-inflammatory drug. World J Surg Oncol 2008;6:17.
13. Poon R, Smits R, Li C, et al. Cyclooxygenase-two (COX-2) modulates proliferation in aggressive fibromatosis (desmoid tumor). Oncogene 2001;20(4):451-60.
14. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guide- lines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92(3):205-16.
15. Mehta S, Belcher HJ. A single-centre cost comparison an- alysis of collagenase injection versus surgical fasciecto- my for Dupuytren’s contracture of the hand. J Plast Re- constr Aesthet Surg 2014;67(3):368-72.
16. Naam NH. Functional outcome of collagenase injections compared with fasciectomy in treatment of Dupuytren’s contracture. Hand (N Y) 2013;8(4):410-6.
17. Church JM. Desmoid tumours in patients with familial adenomatous polyposis. Semin Colon Rectal Surgery 1995;6:29-32.
18. Stoeckle E, Coindre JM, Longy M, et al. A critical analy- sis of treatment strategies in desmoid tumours: a review of a series of 106 cases. Eur J Surg Oncol 2009;35(2):129- 34.
19. Fiore M, Rimareix F, Mariani L, et al. Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment. Ann Surg Oncol 2009;16(9):2587-93.
20. Chew C, Reid R, O’Dwyer PJ. Evaluation of the long term outcome of patients with extremity desmoids. Eur J Surg Oncol 2004;30(4):428-32.
21. Jenkins NH, Freedman LS, McKibbin B. Spontaneous regression of a desmoid tumour. J Bone Joint Surg Br 1986;68(5):780-1.
22. Nakayama T, Tsuboyama T, Toguchida J, et al. Natural course of desmoid-type fibromatosis. J Orthop Sci 2008; 13(1):51-5.