Dermatofibrosarcoma protuberans - recurrence

Case contributed by Bahman Rasuli


Resection of the anteromedial aspect of the left upper thigh mass two years ago. Now referred with the new swelling and mass at the site of surgery.

Patient Data

Age: 35 years
Gender: Female

There is a 25*40*55 mm dermal based, well-defined soft tissue mass protruding from the skin of the anteromedial aspect of the left upper thigh and extending to the subcutaneous fat. The mass demonstrates isointense signal on T1 as compared to muscles and high signal intensity on the fluid sensitive sequences. An oil bead marker has been placed within the medial thigh.

Case Discussion

The recent case was previously diagnosed as dermatofibrosarcoma protuberans after left upper thigh mass excision two years ago as followed:

Microscopic evaluation:

Ill-defined dermal and subcutaneous neoplasm with interfacing fascicles and few storiform growth patterns. Individual monomorphic tumoral cells characterized by a fusiform elongated nucleus with pinpoint ended, fibrillar cytoplasm with indistinct cell borders. Mitotic activity is rare. A few multinucleated giant cells seen. In some area of stroma shows myxoid changes, epidermal appendage and fat cells entrapped by the tumor.

The most common location of dermatofibrosarcoma protuberans tumor is the trunk wall followed by the proximal extremities. The mass has a high local recurrence rate, therefore, multiple follow up is usually indicated. 

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