Skip to main content
SpringerLink
Log in

Successful Low-Dose Chemotherapy Using Vinblastine and Methotrexate for the Treatment of an Ileoanal Pouch Mesenteric Desmoid Tumor: Report of a Case

  • Case Report
  • Published:
Diseases of the Colon & Rectum

ABSTRACT

The purpose of this report was to describe the first known case of ileoanal pouch salvage by a low-dose regimen of vinblastine and methotrexate chemotherapy for the treatment of desmoid tumor arising from the mesentery of the ileoanal pouch in a patient who had undergone ileal pouch-anal anastomosis for familial adenomatous polyposis. Mesenteric desmoid tumor involving the ileoanal pouch in a 28-year-old female was treated with vinblastine and methotrexate biweekly for 12 months and monthly for 12 months in an outpatient unit. The desmoid tumor response to the treatment was assessed at routine intervals by physical examination and magnetic resonance imaging. Desmoid tumor was successfully treated with a low-dose regimen of vinblastine and methotrexate chemotherapy without significant side effects, and function of the ileoanal pouch was fully preserved. Magnetic resonance imaging showed a decrease in desmoid tumor size and cellularity, and changes consistent with fibrosis. This is a unique case highlighting the possibility of ileoanal pouch salvage by low-dose combination chemotherapy using vinblastine and methotrexate in a familial adenomatous polyposis patient with mesenteric desmoid tumor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

REFERENCES

  1. Clark SK, Phillips RK. Desmoids in familial adenomatous polyposis. Br J Surg 1996;83:1494-504

    Google Scholar 

  2. Lewis JJ, Boland PJ, Leung DH, Woodruff JM, Brennan MF. The enigma of desmoid tumors. Ann Surg 1999;229:866-72

    Google Scholar 

  3. Sagar PM, Moslein G, Dozois RR. Management of desmoid tumors in patients after ileal pouch-anal anastomosis for familial adenomatous polyposis. Dis Colon Rectum 1998;41:1350-5

    Google Scholar 

  4. Guy RJ, Mortensen NJ. Successful resection of an ileoanal pouch mesenteric desmoid without pouch sacrifice: report of a case. Dis Colon Rectum 2000;43:713-6

    Google Scholar 

  5. Lotfi AM, Dozois RR, Gordon H, et al. Mesenteric fibromatosis complicating familial adenomatous polyposis: predisposing factors and results of treatment. Int J Colorectal Dis 1989;4:30-6

    Google Scholar 

  6. Heiskanen I, Jarvinen HJ. Occurrence of desmoid tumours in familial adenomatous polyposis and results of treatment. Int J Colorectal Dis 1996;11:157-62

    Google Scholar 

  7. Weiss AJ, Lackman R. Low-dose chemotherapy of desmoid tumors. Cancer 1989;64:1192-4

    Google Scholar 

  8. Skapek SX, Hawk BJ, Hoffer FA, et al. Combination chemotherapy using vinblastine and methotrexate for the treatment of progressive desmoid tumor in children. J Clin Oncol 1998;16:3021-7

    Google Scholar 

  9. Azzarelli A, Gronchi A, Bertulli R, et al. Low-dose chemotherapy with methotrexate and vinblastine for patients with advanced aggressive fibromatosis. Cancer 2001;92:1259-64

    Google Scholar 

  10. Vasen HF, Griffioen G, Offerhaus GJ, et al. The value of screening and central registration of families with familial adenomatous polyposis: a study of 82 families in the Netherlands. Dis Colon Rectum 1990;33:227-30

    Google Scholar 

  11. Arvanitis ML, Jagelman DG, Fazio VW, Lavery IC, McGannon E. Mortality in patients with familial adenomatous polyposis. Dis Colon Rectum 1990;33:639-42

    Google Scholar 

  12. Reitamo JJ, Hayry P, Nykyri E, Saxen E. The desmoid tumor. I. Incidence, sex-, age- and anatomical distribution in the Finnish population. Am J Clin Pathol 1982;77:665-73

    Google Scholar 

  13. Gurbuz AK, Giardiello FM, Petersen GM, et al. Desmoid tumours in familial adenomatous polyposis. Gut 1994;35:377-81

    Google Scholar 

  14. Kasukawa Y, Okada K, Hashimoto M, Sageshima M. Extra-abdominal desmoid tumor of the hand: a case report and review of the literature. Tohoku J Exp Med 1999;189:163-70

    Google Scholar 

  15. Feld R, Burk DJ, McCue P, Mitchell DG, Lackman R, Rifkin MD. MRI of aggressive fibromatosis: frequent appearance of high signal intensity on T2-weighted images. Magn Reson Imaging 1990;8:583-8

    Google Scholar 

  16. Kransdorf MJ, Jelinek JS, Moser RP Jr, et al. Magnetic resonance appearance of fibromatosis. A report of 14 cases and review of the literature. Skeletal Radiol 1990;19:495-9

    Google Scholar 

  17. Healy JC, Reznek RH, Clark SK, Phillips RK, Armstrong P. MR appearances of desmoid tumors in familial adenomatous polyposis. AJR Am J Roentgenol 1997;169:465-72

    Google Scholar 

  18. Tsukada K, Church JM, Jagelman DG, et al. Noncytotoxic drug therapy for intra-abdominal desmoid tumor in patients with familial adenomatous polyposis. Dis Colon Rectum 1992;35:29-33

    Google Scholar 

  19. Easter DW, Halasz NA. Recent trends in the management of desmoid tumors. Summary of 19 cases and review of the literature. Ann Surg 1989;210:765-9

    Google Scholar 

  20. Reich S, Overberg SU, Buhrer C, Henze G. Low-dose chemotherapy with vinblastine and methotrexate in childhood desmoid tumors. J Clin Oncol 1999;17:1086

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Surgery, Asahikawa Medical College, Asahikawa, Japan

    Toru Kono M.D., Ph.D., Ichiro Tomita M.D., Ph.D., Naoyuki Chisato M.D., Minoru Matsuda M.D., Ph.D., Akitoshi Kakisaka M.D., Ph.D. & Shinichi Kasai M.D., Ph.D.

Authors
  1. Toru Kono M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ichiro Tomita M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naoyuki Chisato M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Minoru Matsuda M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akitoshi Kakisaka M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shinichi Kasai M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toru Kono M.D., Ph.D..

About this article

Cite this article

Kono, T., Tomita, I., Chisato, N. et al. Successful Low-Dose Chemotherapy Using Vinblastine and Methotrexate for the Treatment of an Ileoanal Pouch Mesenteric Desmoid Tumor: Report of a Case. Dis Colon Rect 47, 246–249 (2004). https://doi.org/10.1007/s10350-003-0025-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-003-0025-6

Search

Navigation