Here are some quick answers to common questions about desmoid tumors. Remember to always consult with your healthcare provider if you have questions.
A tumor is an abnormal mass of tissue. It forms when cells grow and divide more than they should or do not die when they are supposed to.1
Desmoid tumors are found in tissues that connect, support, and surround other body parts and organs, so they are categorized as soft tissue tumors. Soft tissue (or connective tissue) refers to muscle, fat, nerves, and tendons, which is why desmoid tumors can be found almost anywhere in the body.2,3
Because desmoid tumors are so rare, a desmoid tumor diagnosis can raise more questions for patients than answers. To learn more about desmoid tumors, click here.
If your care team thinks you may have a desmoid tumor, they should consider imaging and a biopsy.4 These tests will help them determine if you have a desmoid tumor and what your course of treatment might look like. Don’t be afraid to ask your doctor about these tests if they have not yet been recommended.
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provides a roadmap to help patients understand their diagnosis and treatment options. According to the NCCN Guidelines®, it’s recommended that both imaging and biopsy are performed.9 Otherwise, a wrong diagnosis can lead to delayed or incorrect treatment, or unnecessary surgery. Your doctor may choose to perform additional tests as well. If you have questions about getting diagnosed, be sure to ask your care team.
It is not clear why some people develop desmoid tumors. However, there are some things that may make certain people more likely to get them than others.
- Women are approximately 2 to 3 times as likely as men to be diagnosed with a desmoid tumor10-12
- Recent pregnancy, injury, or surgery may increase risk as well13,14
- Patients with familial adenomatous polyposis (FAP) have an approximately 850-fold higher risk of developing desmoid tumors than the general population15
If you are diagnosed with a desmoid tumor, you may want to ask your doctor directly about whether it is cancer. They will be able to advise you on the exact status of your tumor and what your next steps might look like.
To learn more about desmoid tumors, click here.
Though they do not metastasize (spread) to other parts of the body, desmoid tumors can grow, and sometimes very quickly.16 Their “tendril-like” growths can attach to and wrap around surrounding tissues and structures.17 If you are diagnosed with a desmoid tumor, your care team may focus on active surveillance to see if your tumor is growing before starting treatment.
You may have heard desmoid tumors described as locally aggressive or invasive. This means that their “tendril-like” growths can attach to and wrap around surrounding tissues and structures.17 As these tumors grow, they can put pressure on blood vessels and nerves, or organs, like your intestines and lungs.16,18
While some people may not feel anything, the impact of desmoid tumors and their “tendril-like” growths wrapping around surrounding structures may cause pain (often neuropathic), changes to body shape and physical function, limited range of motion, sleep changes, shortness of breath, and fatigue.16 While these are some of the physical effects you may experience when living with a desmoid tumor, remember that these effects can be different for each person.2,19
In rare instances, desmoid tumors can be life-threatening depending on where they are located, how they grow, and your overall health.2,3,17,20 However, building a care team with the right specialists can help you get the best care for your specific needs. That’s why it’s so important to talk to your doctor about the location of your tumor and symptoms you may be experiencing.
Currently, there are no FDA-approved treatment options indicated for desmoid tumors.21 Once a desmoid tumor has been diagnosed, there are several management options for you and your HCP to consider depending on the size, location, aggressiveness, and discomfort of the tumor.3,8,9,22 Current management approaches include:
Surgery is an option, but is generally not recommended for first-line treatment by sarcoma specialists.8,17 Doctors will look at the size and location of the tumor, how aggressively it is growing, and the symptoms it’s causing when making a decision about surgery.22 Some people will have part or all of the desmoid tumor surgically removed, often along with some surrounding healthy tissue. Doctors call this surrounding area a “clear margin” where no cancer cells are visible.22
Desmoid tumors can come back after surgery about 24% to 77% of the time,10,26 so it may not be the best treatment option for everyone. And because these tumors grow into surrounding tissues, it may be difficult to identify clear margins.23,25 Risk factors for recurrence include the location and size of the tumor, as well as age.9,27
Talk to your doctor to find out if surgery is an appropriate option for you. Also consider asking for a referral to meet with a sarcoma specialist, who has experience and expertise in dealing with soft tissue tumors.
Right now, there is no FDA-approved medication for desmoid tumors.21 However, there are treatments your care team may prescribe to help shrink and/or stabilize the tumor and manage symptoms.
The recent clinical guideline recommends the following treatment options:8
- Tyrosine kinase inhibitors (TKIs, may include sorafenib, pazopanib and imatinib)
- Chemotherapy (options may include methotrexate and vinblastine/vinorelbine, doxorubicin-based regimens)
- Nonsteroidal anti-inflammatory drugs (NSAIDs, for pain)
Antihormonal therapies (with or without NSAIDs) do not have guideline recommendations.8
Remember, results and side effects can vary from person to person. You may want to talk about what to expect with your care team. Together, you can come up with strategies to help handle side effects if you experience them.
It is recommended that you consult with a multidisciplinary care team for the best approach to your care.22 It may include a medical oncologist and sarcoma specialist, surgeon, radiologist, pathologist, nurses, your primary care physician, and a mental health professional.22,30
A sarcoma specialist is a doctor who has experience and expertise in dealing with soft tissue tumors, like desmoid tumors. For help finding one, you can use this online search tool.*
The following websites are good places to check:†
Advocacy Groups and Additional Resources*
You may find it helpful to reach out to the organizations listed below for information, support, or to connect with others who are living with desmoid tumors.
SpringWorks Therapeutics is providing this link to help patients find a sarcoma specialist by region, but SpringWorks had no role in developing this list and inclusion on this list does not represent an endorsement or a recommendation from SpringWorks for any center or physician.
SpringWorks Therapeutics is providing these links to help patients find more information about desmoid tumors, but inclusion on this list does not represent an endorsement or a recommendation from SpringWorks for any group or organization.
- NCI (National Cancer Institute). Dictionary of cancer terms: desmoid tumor. Accessed April 16, 2022. https://www.cancer.gov/ publications/dictionaries/cancer-terms/expand/D.
- NCI (National Cancer Institute). Desmoid tumor. Accessed April 14, 2022. https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-soft-tissue-tumors/desmoid-tumor.
- Penel N, Chibon F, Salas S. Adult desmoid tumors: biology, management and ongoing trials. Curr Opin Oncol. 2017;29(4):268-274.
- Cancer.Net. Desmoid tumor: diagnosis. Accessed February 6, 2022. https://www.cancer.net/cancer-types/desmoid-tumor/diagnosis.
- Cancer.Net. Magnetic resonance imaging (MRI). Accessed April 16, 2022. https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and- procedures/magnetic-resonance-imaging-mri.
- Cancer.Net. Biopsy. Accessed April 16, 2022. https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/biopsy.
- Carlson JW, Fletcher CDM. Immunohistochemistry for β-catenin in the differential diagnosis of spindle cell lesions: analysis of a series and review of the literature. Histopathology. 2007;51(4):509-514.
- The Desmoid Tumor Working Group. The management of desmoid tumors: a joint global evidence-based consensus guideline approach for adult and pediatric patients. Accessed April 10, 2022. https://dtrf.org/files/2020/02/Desmoid_Paper_2018_A4_RL_Web300-1.pdf.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Soft Tissue Sarcoma V.2.2022. © National Comprehensive Cancer Network, Inc. 2022. All rights reserved. Accessed June 6, 2022. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use, or application, and disclaims any responsibility for their application or use in any way.
- Skubitz KM. Biology and treatment of aggressive fibromatosis or desmoid tumor. Mayo Clin Proc. 2017;92(6):947-964.
- Penel N, Coindre JM, Bonvalot S, et al. Management of desmoid tumors: a nationwide survey of labelled reference centre networks in France. Eur J Cancer. 2016;58:90-96.
- van Broekhoven DLM, Grunhagen DJ, den Bakker MA, van Dalen Thijs, Verhoef C. Time trends in the incidence and treatment of extra-abdominal and abdominal aggressive fibromatosis: a population-based study. Ann Surg Oncol. 2015;22:2817-2823.
- Lopez R, Kemalyan N, Moseley HS, Dennis D, Vetto RM. Problems in diagnosis and management of desmoid tumors. Am J Surg. 1990;159(5):450-453.
- Fiore M, Coppola S, Cannell AJ, et al. Desmoid-type fibromatosis and pregnancy: a multi-institutional analysis of recurrence and obstetric risk. Ann Surg. 2014;259(5):973-978.
- Gurbuz AK, Giardiello FM, Petersen GM, et al. Desmoid tumours in familial adenomatous polyposis. Gut. 1994;35(3):377-381.
- Constantinidou A, Scurr M, Judson I, Litchman C. Clinical presentation of desmoid tumors. In: Litchman C, ed. Desmoid Tumors. Springer; 2012:chap 2. Accessed May 1, 2022. https://www.researchgate.net/publication/226455135.
- Kasper B, Baumgarten C, Garcia J, et al; Desmoid Working Group. An update on the management of sporadic desmoid-type fibromatosis: a European Consensus Initiative between Sarcoma PAtients EuroNet (SPAEN) and European Organization for Research and Treatment of Cancer (EORTC)/Soft Tissue and Bone Sarcoma Group (STBSG). Ann Oncol. 2017;28(10):2399-2408.
- Shinagare AB, Ramaiya NH, Jagannathan JP, et al. A to Z of desmoid tumors. AJR Am J Roentgenol. 2011;197(6):W1008-W1014.
- Gounder MM, Maddux L, Paty J, Atkinson TM. Prospective development of a patient-reported outcomes instrument for desmoid tumors or aggressive fibromatosis. Cancer. 2020;126(3):531-539.
- Joglekar SB, Rose PS, Sim F, Okuno S, Petersen I. Current perspectives on desmoid tumors: the Mayo Clinic approach. Cancers (Basel). 2011;3(3):3143-3155.
- Riedel RF. Agulnik M. Evolving strategies for management of desmoid tumor. Cancer. 2022;128(16):3027-3040.
- Cancer.Net. Desmoid tumor: types of treatment. Accessed April 16, 2022. https://www.cancer.net/cancer-types/desmoid-tumor/types-treatment.
- Kasper B, Baumgarten C, Bonvalot S, et al; Desmoid Working Group. Management of sporadic desmoid-type fibromatosis: a European consensus approach based on patients’ and professionals’ expertise—a sarcoma patients EuroNet and European Organisation for Research and Treatment of Cancer/Soft Tissue and Bone Sarcoma Group initiative. Eur J Cancer. 2015;51(2):127-136.
- Penel N, Cesne AL, Bonvalot S, et al. Surgical versus non-surgical approach in primary desmoid-type fibromatosis patients: a nationwide prospective cohort from the French Sarcoma Group. Eur J Cancer. 2017;83:125-131.
- Ballo MT, Zagars GK, Pollack A, Pisters PWT, Pollock RA. Desmoid tumor: prognostic factors and outcome after surgery, radiation therapy, or combined surgery and radiation therapy. J Clin Oncol. 1999;17(1):158-167.
- Easter DW, Halasz NA. Recent trends in the management of desmoid tumors. Summary of 19 cases and review of the literature. Ann Surg. 1989;210(6):765-769.
- Crago AM, Denton B, Salas S, et al. A prognostic nomogram for prediction of recurrence in desmoid fibromatosis. Ann Surg. 2013;258(2):347-353.
- Mayo Clinic. Cryoablation for cancer. Accessed April 29, 2022. https://www.mayoclinic.org/ tests-procedures/cryoablation-for-cancer/about/pac-20385216.
- Cancer.Net. About clinical trials. Accessed April 16, 2022. https://www.cancer.net/ research-and-advocacy/clinical-trials/about-clinical-trials.
- Cancer.Net. The oncology team. Accessed April 16, 2022. https://www.cancer.net/navigating-cancer-care/cancer-basics/cancer-care-team/oncology-team.