Spindle cell neoplasms encountered in dermatologic surgery: a review

Area of Science:

• Dermatology
• Oncology
• Surgical Pathology

Background:

• Cutaneous spindle cell tumors present diverse clinical, histopathological, and prognostic features.
• Management strategies for these neoplasms are varied, necessitating a comprehensive approach.

Purpose of the Study:

• To analyze scientific literature for codifying clinical, immunohistochemical, and biologic features of cutaneous spindle cell tumors.
• To provide insights into effective management practices, emphasizing Mohs micrographic surgery (MMS).

Main Methods:

• Literature analysis of available scientific studies on cutaneous spindle cell tumors.
• Evaluation of diagnostic, workup, treatment, and surveillance methods.

Main Results:

• Dermatofibrosarcoma protuberans, atypical fibroxanthoma, and other types exhibit varied characteristics.
• Immunohistochemistry aids in differentiating tumor types; further workup may assess invasion or metastasis.
• Mohs micrographic surgery (MMS) demonstrates low recurrence rates and tissue-sparing benefits.

Conclusions:

• Cutaneous spindle cell neoplasms are diverse; immunohistochemistry is crucial for diagnosis.
• Surgery, particularly MMS, is a primary treatment, often combined with adjuvant therapies.
• Close clinical surveillance is essential post-treatment for these tumors.