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Recurrent bilateral dermatofibrosarcoma protuberans of eyelids
Bhavna Chawla1, Neelam Pushker, Seema Sen
1Oculoplastic and Paediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. bhavna2424@hotmail.com
Ophthalmic Plastic and Reconstructive Surgery
|February 25, 2011
Summary
Dermatofibrosarcoma protuberans, a rare skin cancer, can recur aggressively after surgery. This case highlights challenges in achieving local control for this eyelid tumor.
Area of Science:
- Oncology
- Dermatopathology
- Surgical Pathology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is an uncommon malignant neoplasm of the skin.
- DFSP is characterized by a high rate of local recurrence and a low potential for metastasis.
- Eyelid involvement by DFSP presents unique surgical and reconstructive challenges.
Observation:
- A 26-year-old male presented with recurrent bilateral eyelid nodules.
- Previous wide local excision and reconstruction were performed for presumed tumor masses.
- Tumor debulking and reconstructive surgery were performed for recurrent masses.
Findings:
- Histopathology revealed spindle-shaped cells in a storiform pattern within the dermis.
- Immunohistochemistry showed diffuse vimentin and focal CD-34 expression.
- Diagnosis was confirmed as dermatofibrosarcoma protuberans based on histopathology and immunohistochemistry.
Implications:
- This case underscores the aggressive nature and high recurrence rate of DFSP, even after multiple surgical interventions.
- Achieving complete local control for DFSP, particularly in sensitive areas like the eyelids, remains a significant clinical challenge.
- Surgical unresectability at last follow-up indicates the need for further research into advanced treatment modalities for refractory DFSP.
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