Conflicts of interest: None.
Outcomes in 11 patients with dermatofibrosarcoma protuberans treated with Mohs micrographic surgery
Article first published online: 20 DEC 2011
© 2012 The International Society of Dermatology
International Journal of Dermatology
Volume 51, Issue 1, pages 89–93, January 2012
How to Cite
Galimberti, G., Montaño, A. P., Kowalczuk, A., Ferrario, D. and Galimberti, R. (2012), Outcomes in 11 patients with dermatofibrosarcoma protuberans treated with Mohs micrographic surgery. International Journal of Dermatology, 51: 89–93. doi: 10.1111/j.1365-4632.2010.04721.x
- Issue published online: 20 DEC 2011
- Article first published online: 20 DEC 2011
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.