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Dermatofibrosarcoma Protuberans: A Surgeon's Enigma
Siva M Gangadhar1, Mithilesh Yadav1, Nishith S Mandal1
1Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cureus
|September 27, 2023
Summary
Dermatofibrosarcoma protuberans (DFSP) is a rare soft-tissue tumor with high recurrence rates. Early diagnosis and complete wide local excision are crucial for successful management and to prevent patient morbidity.
Area of Science:
- Oncology
- Dermatology
- Surgical Pathology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft-tissue neoplasm originating in the dermis.
- DFSP is characterized by a high propensity for local recurrence, necessitating precise management strategies.
- Standard treatment involves wide local excision (WLE) aiming for tumor-negative margins (R0 resection) or Mohs micrographic surgery (MMS).
Observation:
- A 57-year-old male presented with a recurrent, ulcerated mass on the anterior abdominal wall, having undergone two prior excisions elsewhere.
- Incisional biopsy confirmed Dermatofibrosarcoma protuberans (DFSP).
- The patient was treated with wide local excision (WLE) and subsequent flap reconstruction.
Findings:
- Post-operative histopathology confirmed DFSP with achieved tumor-free margins (R0 resection).
- The case highlights the importance of accurate diagnosis and complete resection in managing DFSP.
Implications:
- Failure to diagnose and manage DFSP effectively in early stages significantly increases the risk of recurrence.
- Timely and appropriate surgical intervention is essential to minimize morbidity associated with recurrent DFSP.
- This case underscores the need for vigilance in differentiating DFSP from more common skin tumors to ensure optimal patient outcomes.
