A Case of Dermatofibrosarcoma Protuberans Arising in a Burn Scar on the Chest Following Electrical Defibrillation

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive skin tumor, and its origin from a burn scar is extremely rare. We report a case of a man in his 60s with DFSP that arose within an electrical burn scar sustained from electrical defibrillation for cardiac arrhythmia 20 years prior. The patient presented with a pedunculated tumor and a nearby subcutaneous nodule on his anterior chest. The diagnosis of DFSP was confirmed by histopathological examination, which revealed a characteristic storiform proliferation of spindle cells, and by immunohistochemistry showing positivity for CD34 and negative for epithelial membrane antigen (EMA), S-100, and alpha-smooth muscle actin (α-SMA). Wide local excision and reconstruction with a latissimus dorsi myocutaneous flap and a split-thickness skin graft were performed. The patient has shown no evidence of recurrence for two years postoperatively. As demonstrated by the subcutaneous nodule in this case, DFSP can be clinically difficult to diagnose. Therefore, careful long-term follow-up and consideration of a skin biopsy, as needed, are crucial for such burn scars.