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Desmoid tumor-associated pain is dependent on mast cell expression of cyclooxygenase-2

Makoto Emori1*, Mitsunori Kaya1, Tomoko Mitsuhashi2, Hiroko Asanuma3 and Toshihiko Yamashita1

Author Affiliations

1 Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- ku, Sapporo 060-8543, Japan

2 Department of Surgical Pathology, Hokkaido University Hospital, West 5, North 14, Kita-ku, Sapporo 060-8648, Japan

3 Department of Surgical Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- ku, Sapporo 060-8543, Japan

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Diagnostic Pathology 2014, 9:14  doi:10.1186/1746-1596-9-14

Published: 20 January 2014



This study aimed to investigate the expression profile of cyclooxygenase-2 (COX-2) in desmoid tumor specimens and to evaluate the correlation of intratumoral COX-2 expression with pain status.


Sixteen patients with histologically proven desmoid tumors who attended our institution between 2003 and 2010 were enrolled in this study. COX-2 protein expression in desmoid tumors was determined by immunohistochemistry. COX-2 - positive cells had similar morphology to that of mast cells, and therefore, immunohistochemical staining for tryptase was performed in co-localized sections. The number of COX-2 -positive cells in 10 consecutive fields was counted at 400× magnification. Patients were stratified into 2 groups according to the number of COX-2- positive cells, the COX-2 -positive group (≧10 COX-2 -positive cells) and the COX-2 -negative group (<10 COX-2 -positive cells). The prevalence of painful tumors was compared between the 2 groups.


COX-2 was expressed in 9 patients (56%). COX-2 proteins were expressed not in tumor cells but in tryptase-positive mast cells in the stroma of desmoid tumors. 6 of 9 patients in COX-2 -positive group had painful tumors. This difference was statistically significant according to the chi-squared test (p = 0 .036), suggesting a positive correlation between COX-2 expression and tumor-associated pain.


Our results indicated that COX-2 secretion from mast cells modulates desmoid tumor-associated pain. In addition, mast cells may at least in part contribute to the pathogenesis of desmoid tumors.

Virtual slide

The virtual slide(s) for this article can be found here: webcite.

Desmoid tumor; Cycloxygenese-2; Mast cell