Breast imaging findings in dermatofibrosarcoma protuberans: Case report and literature review

Dermatofibrosarcoma protuberans (DFSP) of the breast is a rare condition and is often misdiagnosed as benign breast lesions, leading to delays patient treatment. Complete surgical resection with negative margins is the primary treatment option. In this study, we report a case of a patient with DFSP, with clinical and imaging presentations and treatment modalities.

A 15-year-old girl was admitted with a gradually enlarging right breast mass over 3 years. Physical examination revealed symmetrical breasts with no deviation or depression of the nipples, discharge, or orange peel texture or dimpling. A palpable mass of approximately 30 × 25 mm was located in the 2 o'clock position of the right breast.

The imaging characteristics of the breast mass were similar to those of breast fibroadenoma. A preoperative radiological diagnosis of breast fibroadenoma was made; however, postoperative pathology confirmed DFSP.

The patient underwent local resection of the right breast mass under general anesthesia. The diagnosis of a malignant tumor with capsular invasion of the right breast prompted a second surgery 16 days later that involved radical extended resection.

The patient has been followed up regularly for approximately 2 years with no signs of recurrence.

Breast DFSP is frequently misdiagnosed as a benign lesion owing to its imaging characteristics and symptom presentation, risking treatment delays. Surgical resection is the standard treatment; however, nonsurgical treatment is also effective. This study highlights the importance the diagnostic accuracy and treatment of this condition.