Okay, let's tackle this question about the treatment of choice for desmoid tumors. First, I need to recall what desmoid tumors are. They're benign but locally aggressive fibrous tumors, right? They don't metastasize but can cause issues by growing into surrounding tissues.

The question is about the treatment of choice. So, I remember that desmoid tumors are challenging because they can recur after surgery. The treatment depends on factors like size, location, and symptoms. Surgery might not always be possible if the tumor is near critical structures.

Wait, what are the other treatment options? I think non-operative management is sometimes considered if the tumor is small and not causing symptoms. Then there are medications like NSAIDs, tamoxifen, or even chemotherapy agents. But what's the first-line treatment?

Oh right, for operable cases, wide excision is the treatment of choice. But if surgery isn't feasible, maybe other options like radiation or medical therapy are used. However, the primary treatment when possible is surgery. Let me confirm that. Yes, surgical resection with clear margins is the gold standard. So the correct answer should be surgical excision.

Now, the options aren't labeled, but let's assume the answer is C: Surgical excision. Then the other options might be non-surgical options. The incorrect options would include things like watchful waiting, radiation alone, or medications like NSAIDs. Each of these has their place but isn't the first-line treatment.

For the clinical pearl, it's important to note that desmoid tumors have a high recurrence rate if not completely removed. So the key is achieving wide margins during surgery. Also, patients need long-term follow-up because of the risk of recurrence.

I need to make sure that in the explanation, the core concept is about the treatment of desmoid tumors, the correct answer being surgical excision, and explaining why other options are not the first choice. Also, mention the high recurrence rate as a key point. Let me structure the sections as per the user's instructions.

**Core Concept**
Desmoid tumors are benign, locally aggressive fibromatosis that arise from fibroblastic proliferation. Treatment prioritizes complete surgical excision with wide margins to minimize recurrence, as they do not metastasize but infiltrate surrounding tissues.

**Why the Correct Answer is Right**
Surgical excision with wide margins is the treatment of choice for desmoid tumors due to their infiltrative growth pattern. Complete removal reduces recurrence risk, which can exceed 50% with incomplete resection. Surgery is preferred when feasible, especially for symptomatic or enlarging tumors. Adjuvant therapies (e.g., NSAIDs, hormonal agents) are reserved for inoperable cases or when recurrence occurs.

**Why Each Wrong Option is Incorrect**
**Option A:** Radiation therapy is not first-line; it is used for unresectable tumors or postoperative adjuvant therapy.
**Option B:** Watchful waiting is appropriate for asymptomatic, stable tumors but not for active disease.
**Option D:** Chemotherapy (e.g., doxorubicin) is a last-resort option due to limited efficacy and toxicity.

**Clinical Pearl / High-Yield Fact**
Never assume desmoid tumors are malignant—they are benign but aggressive. Recurrence rates are high without complete surgical margins, so preoperative imaging and multidisciplinary planning are critical. For

✓ Correct Answer: A. Surgery