Desmoid tumors of the head and neck are locally invasive neoplasms with a high propensity for inadequate resection and recurrence. The rarity of these neoplasms accounts for the fact that there are no prospective randomized data to evaluate the influence of adjuvant therapies, including radiotherapy, hormonal therapy, or cytotoxic chemotherapy. Several comprehensive retrospective series in the literature suggest that the margin status following resection does not necessarily correlate with local disease recurrence. As a result, we do not advocate the sacrifice of major neurovascular structures in an attempt to obtain negative margins. We present a review of desmoid tumors, emphasizing those occurring in the head and neck, and describe 3 cases that highlight the challenges that the anatomy of the head and neck presents in the management of this difficult disease.
From the *Department of Surgery, †Divisions of Pediatric Surgery, ‡Plastic and Reconstructive Surgery, and §Surgical Oncology, Johns Hopkins School of Medicine, Baltimore, MD.
Received February 4, 2004 and accepted for publication, after revision, June 28, 2004.
Reprints: Anthony P. Tufaro, DDS, MD, Division of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, 8130 D McElderry, 601 N. Caroline, Baltimore, MD 21287-0980. (Tel): 410-955-9846; (fax): 410-614-1296; E-mail: email@example.com.