Objective: Desmoid tumors are rare locally invasive, benign neoplasms that develop along aponeurotic structures. Current treatment is complicated by associated morbidity and high recurrence rates.
Methods: A retrospective, single-institution review identified 23 patients (age 16-77) with extra-abdominal desmoid tumors who received CT-guided percutaneous cryoablation as either a first-line (61%) or salvage (39%) treatment in 30 sessions between 2014 and 2018. Median maximal lesion diameter was 69 mm (range 11-209). Intent was curative in 52% and palliative in 48%. Contrast enhanced cross sectional imaging was obtained before and after treatment in addition to routine clinical follow-up.
Results: Technical success was achieved in all patients. The median follow-up was 15.4 months (3.5-43.4). Symptomatic improvement was demonstrated in 89% of patients. At 12 months, average change in viable volume was -80% (range -100% to +10%) and response by mRECIST was CR 36%, PR 36%, and SD 28%. No rapid post-ablation growth or track seeding was observed. Four patients underwent repeat cryoablation for either residual or recurrent disease. Two patients sustained a major procedural complication consisting of significant neuropraxia.
Conclusions: Cryoablation for desmoid tumors demonstrates a high degree of symptom improvement and local tumor control on early follow-up imaging with relatively low morbidity.