Outcomes in 11 patients with dermatofibrosarcoma protuberans treated with Mohs micrographic surgery

Background  Dermatofibrosarcoma protuberans (DFSP) is an uncommon intermediate‐grade fibrohistiocytic sarcoma. It occurs most often in adults aged 20–50 years and is associated with local invasion and a high recurrence rate. Uncontrolled local disease or metastases may result in death. Treatment has...

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Bibliographic Details
Published in:International journal of dermatology 2012-01, Vol.51 (1), p.89-93
Main Authors: Galimberti, Gastón, Montaño, Anahí Pontón, Kowalczuk, Alicia, Ferrario, Damian, Galimberti, Ricardo
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Dermatofibrosarcoma - surgery
Dermatology
Female
Humans
Male
Medical sciences
Middle Aged
Mohs Surgery
Retrospective Studies
Skin Neoplasms - surgery
Treatment Outcome
Tumors of the skin and soft tissue. Premalignant lesions
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Summary:Background  Dermatofibrosarcoma protuberans (DFSP) is an uncommon intermediate‐grade fibrohistiocytic sarcoma. It occurs most often in adults aged 20–50 years and is associated with local invasion and a high recurrence rate. Uncontrolled local disease or metastases may result in death. Treatment has involved wide excision, Mohs micrographic surgery (MMS) and other approaches. The purpose of the current study was to review our experience with MMS in the treatment of patients with DFSP over the past six years. Methods  We carried out a retrospective chart review for all patients treated with MMS at the Hospital Italiano de Buenos Aires during a six‐year period to October 2009. Patient data included age and sex, site, and prior surgical treatment (if any) of the tumor and details of the Mohs procedure. Results  Eleven patients were treated for DFSP. Four (36.4%) patients had been previously treated with a standard wide excision. Three (27.3%) of the 11 tumors were located on the back, four (36.4%) on the upper extremity, one (9.1%) on the lower extremity, and three (27.3%) on the trunk. Mean lesion size at presentation was 5.16 cm2, and mean defect size was 12.65 cm2, yielding a difference of 7.49 cm2 and a ratio (defect size/lesion size) of 2.45. No tumors recurred after MMS. Conclusions  The recurrence potential of DFSP is directly related to the extent of resection. Mohs micrographic surgery with continuous histological margin control allows for maximum tissue preservation and low recurrence rates and is rapidly emerging as a first‐line treatment modality for this condition.
ISSN:0011-9059
1365-4632
DOI:10.1111/j.1365-4632.2010.04721.x