Pregnancy is a risk factor for desmoid tumors, noncancerous soft tissue growths that can develop anywhere in the body. When they form during or after pregnancy, they most often affect the abdominal wall. Desmoid tumor during pregnancy or the postpartum period is very rare.

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Here’s what to know about the connection between desmoid tumor and pregnancy.

Hormonal Changes in Pregnancy

During pregnancy, the body begins making more estrogen and progesterone. These hormones help support the developing fetus. Estrogen tells the uterus to grow as the fetus grows. Progesterone helps relax the walls of the uterus.

Your estrogen levels are significantly higher during pregnancy than at any other time in the reproductive cycle.

The exact connection between estrogen levels and desmoid tumor is not certain. Historically, researchers reported that some desmoid tumors responded to medications that block estrogen, like tamoxifen.

This finding suggested that there may be a connection between estrogen and desmoid tumor growth. However, hormonal therapies have fallen out of favor for treating desmoid tumor. They may stabilize tumors, but they rarely eliminate them completely.

Changes in the Abdominal Wall During Pregnancy

Another change that occurs in pregnancy is the stretching of the abdominal wall. The abdominal wall includes the skin, connective tissue, and muscle that protect the organs inside your abdomen.

During pregnancy, the muscles in the abdominal wall will stretch to accommodate the growing uterus. Most desmoid tumors associated with pregnancy are in the abdominal wall.

The connective tissue in the abdominal wall is made of a specific type of cell known as a fibroblast. These cells play a role in the formation of connective tissue and wound healing.

A desmoid tumor can form when certain cells mutate (change abnormally) and multiply. Abdominal wall stretching during pregnancy might be a reason why desmoid tumors develop.

Management of Desmoid Tumor in Pregnancy

Finding out you have a desmoid tumor during pregnancy can be a scary experience. Having the right healthcare providers can make the process a little easier.

Your care team may include your obstetrician, oncologists (sometimes called sarcoma specialists), and other support staff.

Your healthcare team will tailor your treatment plan to your symptoms and tumor location. Your care team’s recommendations may be different depending on whether you’re pregnant or if you’ve already delivered your baby.

Recommendations for care may also differ depending on whether you’re currently breastfeeding or plan to breastfeed your baby.

Below are possible treatment options. Desmoid tumor associated with pregnancy is rare, and there isn’t one treatment approach that is firmly shown to be the best.

You’ll need to work closely with your obstetrics team and desmoid tumor team to decide on the best course of action.

Active Surveillance

Active surveillance is usually the preferred approach for managing desmoid tumor associated with pregnancy. This approach is also recommended for the majority of desmoid tumors that are not related to pregnancy.

Active surveillance, also called watchful waiting, means that your healthcare team will monitor your tumor without beginning treatment.

Some people’s tumors shrink on their own without treatment. Your doctor may recommend active surveillance if your tumor is stable (not growing) and isn’t causing any symptoms.

Medications

Often, in people who are not pregnant, systemic medications (drugs that affect the entire body) are recommended for desmoid tumors that progress. These might include targeted therapies or chemotherapy.

The safety labels for certain targeted therapies used for desmoid tumors state that they are not appropriate for pregnancy because they may cause harm to the fetus. There is not enough data specific to people who are pregnant to recommend these medications.

It’s possible to receive chemotherapy during the second and third trimesters, although this is a general recommendation for treating cancer. You’ll need to work closely with your care team to determine what’s best for you.

Make sure to discuss breastfeeding with your doctor because this will help your care team determine the most appropriate treatment.

Cryoablation

Cryoablation is an alternative treatment to surgery. This method uses extremely cold gas to freeze cells and possibly shrink desmoid tumors.

Surgery

Surgical resection (removal) of a desmoid tumor can be an option if its size or location is causing uncomfortable symptoms. It’s generally only recommended as a second-line treatment for abdominal wall desmoid tumors because the recurrence rate is high, but it is not usually recommended for tumors in other locations. Surgery to remove an abdominal wall desmoid tumor can be an appropriate option if you’re pregnant.