Desmoid Tumor in the Late Postoperative Period of PIP Implant Replacement

Abstract

Fibromatosis is an infrequent lesion of connective tissue of unknown etiology, characterized by differentiated fibro-blast proliferation without the characteristics of malignancy. Fibromatosis represents 0.2% of breast tumors. Diagnosis can be confirmed only by histologic study, with the elective treatment being surgical removal. The objective of this article is to present our experience with this unusual tumor that was diagnosed in a patient during the postoperative period of an implant exchange surgery. As fibromatosis is rare but important to consider in the differential diagnoses of breast-implant–associated tumors, a literature review was carried out. In our case, the patient underwent polyimplant prothesis (PIP) replacement and returned 5 months postoperatively with complaints of breast asymmetry caused by a tumor-like lesion arising from the right submammary fold. After a physical examination and complementary studies, an ultrasound-guided needle biopsy was performed, resulting in the presumptive cytologic diagnosis of a neurofibroma. The patient subsequently underwent surgical management with a complete resection of the tumor, preserving the new implants. The final pathological diagnosis of the resected mass was a desmoid tumor. To date, the patient has remained 20 months disease-free. In conclusion, desmoid tumors of the breast are rare, are difficult to diagnose, and require a multidisciplinary approach for surgical management. Additional studies are needed to assure a cause-and-effect relationship between this tumor and the industrial filler used in PIP implants.