Treatment of mesenteric desmoid tumours with the antioestrogenic agent toremifene: case histories and an overview of the literature

Desmoid tumours are histologically benign but due to their infiltration and compression of surrounding structures potentially life-threatening fibroma tous lesions of unknown aetiology, The annual incidence rate is 2-4 per mil lion people, The mesenteric variant constitutes about 10% of all desmoid tu mours, although in familial adenomatous polyposis (FAP) patients this may b e up to 70%, Due to the small number of patients with mesenteric desmoids t he therapy is mainly empirical. This report describes the rationale as well as the value of the short- and long-term treatment (up to 6 years) with th e anti-oestrogenic agent toremifene in combination with sulindac in two pat ients suffering from such a mesenteric desmoid tumour, These patients did n ot respond to sulindac alone and previous treatment with tamoxifen together with this non-steroidal anti-inflammatory drug had also failed, An overvie w of the literature on the management of these dismal tumours is presented, Eur J Gastroenterol Hepatol 11:1179 -1183 (C) 1999 Lippincott Williams & W ilkins.