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Atrophic dermatofibrosarcoma protuberans
Vania Sinovich1, Kevin Hollowood, Susan Burge
1Department of Dermatology, Oxford Radcliffe Hospitals, Oxford, UK. drsvafalk@hotmail.com
The Australasian Journal of Dermatology
|April 22, 2005
Summary
Dermatofibrosarcoma protuberans can present as an atrophic plaque, mimicking benign dermatofibroma. Re-examination of biopsy specimens with CD34 staining confirmed this rare diagnosis, leading to successful surgical treatment.
Area of Science:
- Dermatopathology
- Surgical Oncology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade malignant skin tumor.
- DFSP can present with diverse clinical morphologies, sometimes mimicking benign lesions.
- Accurate diagnosis is crucial for appropriate management and preventing recurrence.
Observation:
- A 48-year-old woman had a 20-year history of an asymptomatic abdominal plaque.
- Initial biopsy 5 years prior diagnosed dermatofibroma; however, lesion progression prompted re-evaluation.
- Histochemical staining for CD34 on new and prior biopsies revealed DFSP.
Findings:
- Re-examination of biopsy specimens confirmed atrophic dermatofibrosarcoma protuberans.
- CD34 staining is a key diagnostic marker for differentiating DFSP from dermatofibroma.
- Wide local excision resulted in no recurrence at 9 months follow-up.
Implications:
- This case highlights the importance of considering DFSP in the differential diagnosis of persistent or evolving skin plaques.
- Histopathological review and immunohistochemistry are essential for accurate diagnosis of challenging cases.
- Early and complete surgical excision is critical for favorable outcomes in DFSP.