Desmoid Tumor Management Chalanges: A Case Report and Literature Review on the Watch-and-Wait Approach in Recurrent Thoracic Fibromatosis

Desmoid tumors are rare mesenchymal neoplasms arising from locally invasive fibroblasts. While they lack metastatic potential, they exhibit high local recurrence rates and can cause significant tissue destruction. We present the case of a 39-year-old female patient who initially presented with epigastric pain, pyrosis, and a palpable, firm, painless mass in the left upper quadrant, extending to the left hemithorax. Her medical history included treated cervical neoplasia. Clinical evaluation, imaging studies, and histopathological analysis suggested aggressive fibromatosis. The patient opted for a partial surgical excision, which resulted in tumor recurrence one year later, with infiltration of the ribs near the sternum. Despite oncological recommendations favoring conservative management, she opted for a second surgical intervention, involving an en-bloc resection of the tumor, the affected sternum and ribs, followed by thoracic wall reconstruction.