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 fibromatous lesions of unknown aetiology, The annual incidence rate is 2-4 per million people, The mesenteric variant constitutes about 10% of all desmoid tumours, although in familial adenomatous polyposis (FAP) patients this may be up to 70%, Due to the small number of patients with mesenteric desmoids the 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 the anti-oestrogenic agent toremifene in combination with sulindac in two patients suffering from such a mesenteric desmoid tumour, These patients did not respond to sulindac alone and previous treatment with tamoxifen together with this non-steroidal anti-inflammatory drug had also failed, An overview of the literature on the management of these dismal tumours is presented, Eur J Gastroenterol Hepatol 11:1179 -1183 (C) 1999 Lippincott Williams & Wilkins.