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Dermatofibrosarcoma protuberans: lumbar region

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Recurrent lumbar region swelling. Recent swelling for last 6-8 months. At least 3 local surgeries done. Last surgery in 2005. 1st surgery probably in 1983. No details of surgery / treatment / histopathology available.

Patient Data

Age: 55 years old
Gender: Female

There is presence of generalized osteopenia. There is no lysis or listhesis.  

There is sclerosis on iliac side of both sacroiliac joints with normal joint space, in keeping wiht osteitis condensans ilii.

There is soft tissue bulge in lumbar region on the lateral radiograph.

There is a lobulated well-defined ovoid lesion in region of interest.

Size: approximately 70 x 45 x 25 mm

Location: Lesion is in subcutaneous plane. Lesion abuts skin, muscle and spinous processes.

Morphology: Solid, Hypoechoic without calcification / cystic changes. Few lobulations present. Posterior acoustic enhancement present.Not significantly compressible.

Doppler: Few flow signals are present.     

Case Discussion

Surgical excision was done. Histopathology revealed dermatofibrosarcoma protuberans.

 

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