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Dermatofibrosarcoma protuberans in an adolescent: a case report and review of the literature
Ausilia M Manganoni1, Laura Pavoni, Giulio Gualdi
1Department of Dermatology, University Hospital Spedali Civili, Brescia, Italy. manganoni@spedalicivili.brescia.it
Insights
Dermatofibrosarcoma protuberans (DFSP) is rare in children, but this case highlights the need for biopsy in persistent skin lesions. Early diagnosis and wide excision offer good outcomes for pediatric DFSP.
Area of Science:
- Oncology
- Dermatology
- Pediatric Oncology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is typically an adult disease, but pediatric cases are increasingly reported.
- This suggests a potential underestimation of DFSP incidence in younger populations.
- Reviewing pediatric DFSP literature provides insights into this rare condition.
Observation:
- A 14-year-old male presented with a slow-growing, pale brownish neck lesion.
- Histological examination confirmed a diagnosis of dermatofibrosarcoma protuberans (DFSP).
- The patient underwent wide surgical excision with 3 cm margins, including underlying fascia.
Findings:
- The patient experienced no recurrence over a 6-year follow-up period.
- This case represents the 183rd histologically confirmed pediatric DFSP reported.
- Surgical management with wide margins appears effective for pediatric DFSP.
Implications:
- Emphasizes the importance of biopsy for persistent or atypical cutaneous plaques/nodules in children.
- Accurate histological diagnosis is crucial for appropriate management of pediatric DFSP.
- Increased awareness and knowledge of DFSP in pediatric populations are necessary for timely recognition and treatment.
Abstract:
Classically, dermatofibrosarcoma protuberans (DFSP) is a disease of adults. The world literature revision shows that several pediatric cases have been reported so far; this might suggest that the number of infants with the condition might be larger than that estimated previously. Here, we report the 183rd case of histologically confirmed DFSP in young age. A 14-year-old white male patient came under our care for a slowly growing, pale brownish lesion on the neck skin. A biopsy specimen showed a DFSP. Subsequently, a wide surgery excision with 3 cm of resection margins including the underlying fascia was performed. To date, the patient has been in follow-up for 6 years without evidence of recurrent disease. The clinical features and treatment of DFSP diagnosed in childhood and adolescence reported in the published literature are reviewed to provide new insights about this rare entity. The aim is to emphasize the importance of biopsy for histologic evaluation in the cases that show a persistent or a large cutaneous plaque or nodule without pathognomonic clinical features that permit a clinical diagnosis. An accurate knowledge of the disease is the prerequisite for a wider recognition and appropriate treatment.
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