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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

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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.

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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.