Metastasising dermatofibroma or dermatofibroma-like dermatofibrosarcoma protuberans?

Dermatofibroma is a relatively common cutaneous fibrohistiocytic tumour with a marked tendency to recur locally. It is almost invariably benign. In a review of the world literature there was one report of two patients with dermatofibroma with histologically documented metastases. In both of these there was local recurrence and subsequent metastasis to lymph nodes and haematogenous spread to the lungs. We present a case of cellular dermatofibroma of the lower limb with local recurrence and metastasis to the abdominal wall, posterior chest wall and both lungs 30 months after excision of the primary lesion. The clinical and pathological features of the case are presented to emphasis the need for follow up of patients with dermatofibroma which present any unusual histological features.