Excision of a giant cervical-thoracic aggressive fibromatosis: a case report and review of literature.

Abstract

Background: Aggressive fibromatosis is a rare, locally invasive tumor with a marked tendency to recur, and it is often diagnosed only after the lesion has already reached a considerable size. Although histologically benign, these tumors can behave aggressively at the local level.

Case description: We report the case of a male patient with a large mass occupying the entire left hemithorax and extending into the left side of the neck. The tumor compressed the surrounding organs and produced corresponding symptoms. It encircled the left subclavian artery and vein. The patient underwent a complete surgical excision of the mass and is currently under regular follow-up. Because these tumors are large and tend to compress adjacent organs and infiltrate neighboring blood vessels, complete excision can be technically demanding. Histopathological examination confirmed aggressive fibromatosis. Postoperative chest X-ray showed good re-expansion of the left lung. The patient developed lymphoedema which resolved after two weeks of compression bandaging. He recovered well and was discharged. He declined postoperative radiotherapy and was followed up by telephone for 11 months without evidence of disease recurrence or significant discomfort. However, no further radiological follow-up was performed due to financial constraints.

Conclusions: Surgery remains the mainstay of treatment, with adjunctive radiotherapy used to reduce the risk of local recurrence.