European Journal of Molecular & Clinical Medicine

Abstract

Aim: Dermatofibrosarcoma Protuberans (DFSP) is a rare locally aggressive spindle cell soft tissue neoplasm with high rate of local recurrence and rare distant site metastasis. Our study aimed to analyze the pattern of recurrence, best possible surgical treatment and factors preventing its recurrence.
Methods: We studied prospectively 10 patients of recurrent DFSP attending to Gujarat Cancer Research Institute & M.P. Shah Regional Cancer Hospital, Ahmedabad, India from January to December 2015. All patients evaluated clinically, pathologically and radiologically. We also analysed oncologic and aesthetic outcome after a minimum follow up period of 12 months.
Results: 8 males and 2 females (M:F=4:1), with average age of 44.8 years (range 16-75), presented with recurrent chest wall DFSP - 06 patients with 1st recurrence; 02 patients with 2nd recurrence; 01 patient with 3rd recurrence and 01 patient was not actually recurrent rather with positive previously excised mass margin. The average duration of recurrence was 14.6 months (range 6-36 months). The average size of the tumour was 58.2cm2 (range 5×3-15×12 cm2) located over superior presternal (05 cases), parasternal (03 cases), axilla (01 case) and breast (01 case). 01 patient had lung metastasis since the previous surgery for which he took Imatinib Mesylatedefaultly . All 10 patients underwent wide local excision of mass including scars with a minimum margin of 3 cm in all directions. 08 patients reconstructed with local myocutaneous flap. Based on histopathology, 01 patient required postoperative adjuvant radiotherapy. After minimum follow up of 12 months all are oncologically and aesthetically well.   
Conclusion: Dermatofibrosarcoma Protuberans is a locally aggressive neoplasm notorious for recurrence. Accurate diagnosis and wide local excision with at least 3 cm margin with reconstruction at the time of first surgery as well as proper histopathologically directed adjuvant radiotherapy or chemotherapy can prevent recurrence.