MRI-guided cryoablation for recurrent pediatric hand desmoid tumor: A longitudinal case report

Desmoid fibromatosis of the hand is rare, with fewer than 20 cases reported in the literature. We present a 14-year-old girl with a right-hand desmoid tumor who sought non-radiation focal treatment after five prior surgical resections. The tumor overlaid the extensor compartment of her dorsal hand and caused pain and progressive hyperextension of the second and third fingers. She was initially evaluated for CT-guided cryoablation but was not a candidate due to limited visibility, and was therefore selected for MRI-guided cryoablation given its superior visualization of the iceball. She was safely treated four times over a five-year span, targeting areas of active pain and tumor growth during a period that included a concomitant pubertal growth spurt. MRI-guided cryoablation provided safe, effective, and durable local control for a recurrent pediatric hand desmoid tumor when further surgery and radiation were not desired, and it may offer a viable non-radiation alternative for select patients with extra-abdominal desmoid disease.