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Multiple recurrent dermatofibrosarcoma protuberans of the hand
Efterpi C Demiri1, Dimitrios D Dionyssiou, John M Kirkos
1Department of Plastic Surgery, Aristotle University of Thessaloniki, Greece.
Summary
This case study highlights successful treatment of a recurrent dermatofibrosarcoma protuberans on the hand using radical surgery and a skin flap. The patient achieved a functional outcome with no signs of recurrence after 40 months.
Area of Science:
- Dermatologic Surgery
- Surgical Oncology
- Hand Surgery
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive skin cancer.
- Recurrent DFSP on the hand presents significant surgical challenges.
- Optimal treatment for DFSP typically involves wide surgical excision.
Observation:
- A 51-year-old woman with a history of four DFSP recurrences on her hand dorsum.
- The patient underwent radical surgical excision and reconstruction with a distal ulnar artery skin island flap.
- Adjuvant radiation therapy was administered post-operatively.
Findings:
- The patient achieved a functional hand with no evidence of disease recurrence at 40 months post-surgery.
- Radical excision with wide margins is considered optimal for DFSP.
- Less extensive surgery combined with radiotherapy may be a viable alternative for complex cases, preventing mutilation.
Implications:
- This case demonstrates the efficacy of combining radical surgery with flap reconstruction and adjuvant radiotherapy for challenging DFSP.
- Such combined approaches can preserve hand function while managing aggressive tumors.
- This strategy may reduce recurrence rates and the risk of metastasis in difficult-to-treat DFSP cases.
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