A 40-year-old woman who underwent total abdominal colectomy for familial adenomatous polyposis (FAP) 5 years ago presents with a gradually expanding painless 4 cm mass of the anterior abdominal wall. A biopsy is returned as "desmoid tumor with no sign of malignancY:' The correct management is:
A. ObservationDesmoid tumors of the abdominal wall are fibrous neoplasms that occur sporadically or in the setting of familial adenomatous polyposis (FAP). The condition can result in mortality due to aggressive local growth, so radical excision with confirmation of tumor-free margins of resection is required. Medical treatment with an antineoplastic agent such as doxorubicin, dacarbazine, or carboplatin can produce remission but the prognosis of advanced desmoids is poor.