Dermatofibrosarcoma- An uncommon entity, commonly mismanaged: a case report.

Area of Science:

• Oncology
• Dermatology
• Surgical Pathology

Background:

• Dermatofibrosarcoma protuberans (DFS) is a rare, slow-growing cutaneous soft tissue sarcoma.
• DFS has a low metastatic potential but a high recurrence rate.
• Misdiagnosis as benign conditions like cysts or lipomas is common, delaying appropriate management.

Purpose of the Study:

• To highlight a case of delayed diagnosis of Dermatofibrosarcoma protuberans (DFS).
• To emphasize the importance of considering DFS in the differential diagnosis of long-standing parietal wall swellings.
• To underscore the challenges in managing recurrent DFS.

Main Methods:

• A case report of a 33-year-old male with a 15-year history of an abdominal lump.
• Diagnostic workup included imaging and aspiration cytology, confirming DFS.
• Treatment involved wide local excision with negative margins.

Main Results:

• A 15-year diagnostic delay occurred before DFS was correctly identified.
• The patient experienced recurrence four years after initial excision.
• Wide local excision achieved negative margins in this case.

Conclusions:

• Delayed diagnosis of DFS is often due to its asymptomatic and indolent nature, coupled with low physician awareness.
• Community doctors should include DFS in the differential for persistent, asymptomatic parietal wall swellings, especially with a history of recurrence.
• Subsequent excisions for recurrent DFS may complicate wound closure and reconstruction.