Multidisciplinary management of breast fibromatosis with chest wall resection and reconstruction: a case report
DOI:
https://doi.org/10.29289/2594539420250049Keywords:
fibromatosis, breast neoplasms, desmoid tumor, surgical proceduresAbstract
Breast fibromatosis, also known as desmoid tumor of the breast, is a rare and benign condition, yet it is locally aggressive and prone to recurrence. Due to its infiltrative nature, early diagnosis and surgical excision with wide margins are essential to minimize the risk of recurrence and preserve function and aesthetics. We report the case of a 45-year-old female patient who presented with a palpable mass in the inframammary fold of the left breast. Imaging studies and a core needle biopsy suggested fibromatosis. The diagnosis was confirmed through excisional biopsy and immunohistochemical analysis. Surgical resection of the chest wall tumor was performed in a multidisciplinary approach involving mastology, thoracic surgery, and plastic surgery teams. The resection included part of the sternum and ribs, followed by reconstruction using a latissimus dorsi flap and chest wall prosthetic materials. Histopathological and immunohistochemical examination of the surgical specimen confirmed the diagnosis of breast fibromatosis, with tumor-free margins. The patient had an excellent functional and aesthetic outcome and remains disease-free after 1 year of follow-up. This case highlights the importance of a multidisciplinary approach in managing breast fibromatosis, a rare but challenging entity. Long-term follow-up is necessary to detect potential recurrences, which are not uncommon despite complete excision.
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1. Lee SM, Lee JY, Lee BH, Kim SY, Joo M, Kim J Il. Fibromatosis of the breast mimicking an abscess: Case report of unusual sonographic features. Clin Imaging. 2015;39(4):685-8. https://doi.org/10.1016/j.clinimag.2015.03.002
2. Bhat D, Wear V, Weisenberg E, Alvarado R. Desmoid-type fibromatosis of the breast: A case report. Breast Dis. 2016;36(4):149-52. Disponível em: https://doi.org/10.3233/BD-160227
3. Ng WH, Lee JS, Poh WT, Wong CY. Desmoid tumor (fibromatosis) of the breast: A clinician’s dilemma - A case report and review. Arch Surg. 1997;132(4):444-6. https://doi.org/10.1001/archsurg.1997.01430280118021
4. Ha KY, Deleon P, Hamilton R. Breast fibromatosis mimicking breast carcinoma. Proc (Bayl Univ Med Cent). 2013;26(1):22-4. https://doi.org/10.1080/08998280.2013.11928903
5. Taylor TV., Sosa J. Bilateral breast fibromatosis: case report and review of the literature. J Surg Educ. 2011;68(4):320-5. https://doi.org/10.1016/j.jsurg.2011.02.001
6. Leibman AJ, Kossoff MB. Sonographic features of fibromatosis of the breast. J Ultrasound Med. 1991;10(1):43-5. https://doi.org/10.7863/jum.1991.10.1.43
7. Ebrahim L, Parry J, Taylor DB. Fibromatosis of the breast: a pictorial review of the imaging and histopathology findings. Clin Radiol. 2014;69(10):1077-83. https://doi.org/10.1016/j.crad.2014.05.105
8. Nakazono T, Satoh T, Hamamoto T, Kudo S. Dynamic MRI of fibromatosis of the breast. ARJ Am J Roentgenol. 2003;181(6):1718-9. https://doi.org/10.2214/ajr.181.6.1811718
9. Chummun S, McLean NR, Abraham S, Youseff M. Desmoid tumour of the breast. J Plast Reconstr Aesthet Surg. 2010;63(2):339-45. https://doi.org/10.1016/j.bjps.2008.09.024
10. Li A, Lui CY, Ying M, Mak KL, Lam HS. Case of fibromatosis of male breast. Australas Radiol. 2007;51 Spec No.:B34-6. https://doi.org/10.1111/j.1440-1673.2007.01803.x
11. Rosen PP, Ernsberger D. Mammary fibromatosis. A benign spindle‐cell tumor with significant risk for local recurrence. Cancer. 1989;63(7):1363-9. https://doi.org/10.1002/1097-0142(19890401)63:7<1363::aid-cncr2820630722>3.0.co;2-b
12. Plaza MJ, Yepes M. Breast fibromatosis response to tamoxifen: dynamic MRI findings and review of the current treatment options. J Radiol Case Rep. 2012;6(3):16-23. https://doi.org/10.3941/jrcr.v6i3.897
13. Cederlund CG, Gustavsson S, Linell F, Moquist-Olsson I, Andersson I. Fibromatosis of the breast mimicking carcinoma at mammography. Br J Radiol. 1984;57(673):98-101. https://doi.org/10.1259/0007-1285-57-673-98
14. Bouab M, Harit A, Boufettal H, Mahdaoui S, Samouh N. Desmoid fibromatosis of the breast occurring after breast reduction surgery mimicking a carcinoma: A rare case report. Ann Med Surg (Lond). 2022;77:103526. https://doi.org/10.1016/j.amsu.2022.103526
15. Wongmaneerung P, Somwangprasert A, Watcharachan K, Ditsatham C. Bilateral desmoid tumor of the breast: case seriesand literature review. Int Med Case Rep J. 2016;9:247-51. https://doi.org/10.2147/IMCRJ.S106325
16. Olvera-Caballero C, Acosta-Ponce de Leon E, Sanchez-Sosa S. Functional and Aesthetic Thorax Reconstruction after Desmoid Tumor Resection. Plast Reconstr Surg Glob Open. 2017;5(2):e1248. https://doi.org/10.1097/GOX.0000000000001248
17. Kilmartin C, Westover C, Raghavan S, Dillon PM, Campbell CA. Desmoid Tumor and Implant-Based Breast Reconstruction. Case Rep Oncol. 2023;16(1):74-80. https://doi.org/10.1159/000525350
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Copyright (c) 2025 Fernanda Otsuka Gomes de Lima, Rafael Henrique Szymanski Machado
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