Mesenteric desmoid tumor in Gardner's syndrome treated by sulindac

Abstract

Mesenteric desmoid tumors are a recognized sequela of colectomy for polyposis coli of Gardner's type. Relentless growth and recurrence carry a poor prognosis. Recently, nonsteroidal anti-inflammatory drugs have been used to halt the growth of these tumors, presumably by interfering with prostaglandin metabolism. A 36-year-old man presented with small-bowel obstruction secondary to a large, diffuse mesenteric desmoid six years following colectomy and ileoproctostomy. Laparotomy revealed it to be unresectable. Postoperatively, he was started on sulindac (Clinoril) 100 mg twice a day. His obstruction resolved, and he remains well at 11 months. A CT scan shows diminution in the size of the tumor. Nonsteroidal anti-inflammatory agents may be an alternative to chemotherapy and radiotherapy in treating mesenteric desmoids.