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Desmoplastic fibroma versus soft-tissue desmoid tumour of forearm: a case series of diagnosis, surgical approach, and outcome

We report a case series of aggressive fibromatosis of the forearm and discuss the differentiation criteria of overlapped intra- or extra-osseous origin of aggressive fibromatosis, surgical approach, and outcome. Ten cases of aggressive fibromatosis of the forearm were evaluated. When there was no involvement of vital adjacent structures, such as nerves, vessels, and tendons, en-bloc excision was performed for the removal of the soft-tissue mass. Bone involvement was observed in nine cases. Intercalary allograft was performed whenever one of the forearm bones was involved (six cases), while extensive curettage was used if both forearm bones were affected (three cases). The mean Musculoskeletal Tumor Society Score was 90%, ranging from 80% to 97%. Limited forearm rotation was the most frequent complication. Three local recurrences were observed, none with intercalary allograft reconstruction. We conclude that the extensive curettage of the involved bone results in a higher risk of local recurrence compared with intercalary allograft. Level of evidence: IV