Related Experiment Videos
Management of scalp dermatofibrosarcoma protuberans
Lesley Loss1, Nathalie C Zeitouni
1Department of Dermatology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
Summary
Mohs micrographic surgery offers the best treatment for scalp dermatofibrosarcoma protuberans, minimizing recurrence. Advanced reconstruction is often necessary after tumor removal for these rare soft tissue tumors.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatopathology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft tissue tumor.
- Scalp DFSP accounts for <5% of cases but has high recurrence rates.
- Standard management includes wide local excision and Mohs micrographic surgery.
Observation:
- A review of 28 scalp DFSP cases (5 RPCI, 23 literature) analyzed treatment outcomes.
- Tumor characteristics, surgical methods, reconstruction, and recurrence rates were compiled.
- Seven tumors invaded beyond the periosteum, indicating deep tissue involvement.
Findings:
- Mohs micrographic surgery (MMS) or modified MMS may be optimal for scalp DFSP.
- MMS required 2-4 layers for complete tumor removal.
- Four patients experienced recurrence after initial treatment; three had multiple recurrences.
- Advanced reconstruction was frequently needed to close surgical defects.
Implications:
- MMS is recommended for scalp DFSP to maximize tumor clearance and reduce recurrence.
- Surgical teams must be prepared for complex reconstruction following tumor excision.
- Further research into optimal surgical margins and adjuvant therapies for scalp DFSP is warranted.