goserelin and Fibroma

Two female patients with desmoid tumors (aggressive fibromatosis) showed tumor regression after endocrine therapy. In one patient, tumor response to tamoxifen has been maintained over several years of treatment. In the second patient, who had inoperable mesenteric fibromatosis, the tumor progressed on tamoxifen but regressed after treatment with Zoladex (goserelin acetate, ICI, Melbourne, Australia) and medroxyprogesterone acetate (MPA). To the authors' knowledge this is the first report of the use of Zoladex in the treatment of desmoid tumors. This review of the literature reveals that the biology of this disease is related to the endogenous hormonal environment and that estrogen receptors have been documented in desmoid tumors. Thirty-five cases are identified where endocrine agents have been employed, with a response rate of 51%. Furthermore, tumors may respond to second-line hormonal therapy after failing to respond to initial endocrine treatment. Endocrine treatments have also been used in other disorders of fibroblastic origin. The authors recommend that endocrine treatment be employed in inoperable desmoid tumors or where there has been postsurgical recurrence. In addition, the role for endocrine therapy in other soft tissue neoplasms should be determined.

Topics: Adult; Buserelin; Female; Fibroma; Goserelin; Humans; Intestinal Neoplasms; Intestine, Small; Leg; Tamoxifen

Four patients are described with familial adenomatous polyposis and an intra-abdominal desmoid tumour located in the mesentery of the small bowel; the fifth patient had a tumour in the abdominal wall. In all patients a colectomy had been performed several years prior to the development of the tumours. Radical resection of the desmoid tumours was not possible because of the location in the mesentery; repeated resection or partial excision was performed in all four patients. NSAIDs, tamoxifen, norethisterone and interferon alpha appeared to have only a temporary effect on the growth of the desmoid tumour. The effect of goserelin, a gonadorelin analogue, on the behaviour of the desmoid tumour appears promising, as two patients treated with it showed no tumour growth after 4 and 16 months respectively.

Topics: Abdominal Neoplasms; Adenomatous Polyposis Coli; Adult; Combined Modality Therapy; Female; Fibroma; Gardner Syndrome; Goserelin; Humans; Male; Recurrence

The administration of GnRH agonists to shrink fibroids, albeit temporarily, may be of benefit to those patients in whom tubal blockage by the fibroids has given rise to infertility. Tubal patency has been restored in two of our patients, resulting in pregnancy in one.

Topics: Adult; Buserelin; Fallopian Tube Patency Tests; Fallopian Tubes; Female; Fibroma; Goserelin; Humans; Pregnancy; Uterine Neoplasms