Surgical Management of Dermatofibrosarcoma Protuberans

Abstract

Background:Dermatofibrosacoma protruberans (DFSP) is a rare, low to intermediate grade
cutaneous sarcoma, with recurrence rates as high as 60%.
Material & Methods:11 patients were treated over a period of 5 years in Sheikh Zayed Hospital
Lahore .
Results: The tumors presented as asymptomatic nodule in 63.6% cases. Average size of tumor
at the time of presentation was 8.5x6.6cm. Wide Local Excision (more than 3 cm) was done to
reduce the chances of recurrence. Reconstruction of the excised lesions was carried out in the
same sitting after frozen section examination of the tumor and margin clearance. 10 patients
(90.1%) were free from recurrence after a follow up of 24 months.
Conclusion: Dermatofibrosarcoma protuberans is a rare, indolent tumor that presents as a local
problem. Wide excision of margins has a favorable impact on recurrence free life interval. Frozen
section analyses, margin clearance and reconstruction should be carried out during one
operation. Fibrosarcoma variant of DFSP may behave more aggressively and radiation therapy
may have a role in controlling recurrence of this sub group of tumor. We advocate wide local
excision as an effective measure to control local recurrence of the indolent tumor.