What is the treatment of choice in desmoid tumors

Desmo means Band/Tendon in Greek. It is a tumour arising from the musculoaponeurotic layer of abdomen, below the level of the umbilicus. It is unencapsulated, hard, fibroma, presently classified under aggressive fibromatosis.80% of cases occur in women, commonly after deliveries, over the abdominal scars, OCP use.It is often associated with Gardner's syndrome. Wide excision of the tumour with a margin of 2.5 cm along with placement of a mesh to the abdominal defect is the treatment of choice. It is moderately radiosensitive. Drugs like sulindac and tamoxifen are also used. Chemotherapeutic agents like doxorubicin, actinomycin D, dacarbazine, carboplatin are used but with significant toxicity. Recurrence rate is high--20-40%. Reference : page 742-43 SRB's manual of surgery 5th edition.