• Elise M Bekers, Danique L M van Broekhoven, Thijs van Dalen, Johan J Bonenkamp, Ingrid C M van der Geest, Jacky W J de Rooy, Joost M van Gorp, David H Creytens, Wendy W J de Leng, Blanca Scheijen, Astrid Eijkelenboom, and Uta Flucke.
• Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Pathologie (DNA), Jeroen Bosch Hospital, Den Bosch, The Netherlands.
• Ann Diagn Pathol. 2018 Aug 1; 35: 38-41.

AbstractDesmoid-type fibromatosis, also called desmoid tumor, is a locally aggressive myofibroblastic neoplasm that usually arises in deep soft tissue with significant potential for local recurrence. It displays an unpredictable clinical course. β-Catenin, the genetic key player of desmoid tumors shows nuclear accumulation due to mutations that prevent its degradation leading to activation of Wnt signaling and myofibroblastic cell proliferation. The corresponding hot spot mutations are located in exon 3 of the CTNNB1 gene or alternatively, in the APC tumor suppressor gene, most often as a germline mutation. Multifocal desmoid tumors are very rare and clinical characteristics are poorly understood. Here we present six sporadic and one familial case of multifocal desmoid tumors. Four female and three male patients, aged between 7 and 30 years (mean 18.4 years) were identified in a cohort of 1392 cases. Tumors were located in (distal) extremities, thorax, breast, abdominal wall, shoulder, and neck. Four cases showed a CTNNB1 mutation and one an APC germline mutation. In two sporadic cases no CTNNB1 mutation was identified. Four patients showed (multiple) recurrences and one patient was lost to follow-up. In conclusion, multifocal desmoid tumors are a very rare disease and may occur in sporadic cases that are characterized by recurrent CTNNB1 mutations. However, the underlying pathogenesis of multifocal desmoid tumors remains poorly understood with often aggressive clinical behavior and challenging therapeutical management.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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