Dermatofibrosarcoma protuberans

Case contributed by Ammar Ashraf


Painless swelling with off and on bloody discharge right lower back for six years. Slowly increasing in size over last two years.

Patient Data

Age: 55 years
Gender: Male

Well-defined homogeneous oval shape hypoechoic lesion measuring about 5 x 15 mm in the superficial subcutaneous soft tissues of the right lumbar region. No vascularity is seen in it. 

3 years later


Significant interval change in the size (now measuring 2.4 x 3.9 cm) and echogenicity (now looking very heterogeneous) of the previously noted well-defined homogeneous hypoechoic lesion. There is also interval development of moderate internal vascularity. 

Well-defined oval shape mass lesion in the subcutaneous soft tissues of the right back at T12-L1 level. The lesion is mildly hypointense on T1, heterogeneously hyperintense on T2 and shows mild diffusion restriction and moderate homogeneous enhancement. No fat component or hemorrhage is seen. No invasion of the deeper tissues is seen.  


Procedure: Ultrasound guided tru-cut biopsy followed by the complete excision.

Diagnosis: Dermatofibrosarcoma protuberans. No fibrosarcomatous component is seen.

Case Discussion

Well-defined mass in the subcutaneous soft tissues of the right back opposite to T12-L1 level. Prime differential diagnosis is dermatofibrosarcoma protuberans; however, possibility of a neoplastic lesion, like soft tissue sarcoma cannot be entirely excluded.

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