Subcutaneous dermatofibrosarcoma protuberans in parotid region: Case report

Abstract

Dermatofibrosarcoma protuberans (DFSP) is a low-grade soft tissue sarcoma (fibrosarcoma) originated from dermal and subdermal layer of the skin. But subcutaneous localization is quite rare. It is one of the rare tumors and accounts for 0.1% of all malignancies. The tumor infiltrates into the deeps in the villous and finger shape. For this reason, it is quite difficult to get surgical margins in the tumor excision and the recurrence is a problem encountered frequently. An excision or Mohs technique of micrographic surgery is suggested by leaving a surgical space up to 5 cm from the tumor margines. In this case report, a case with DFSP atypically subcutaneous localized on superficial parotis gland was presented. It should be kept in mind that probability of the microscopic spread is high in these patients and they should be followed by reminding that the disease can recur in the following long years.

Keywords

• Subcutaneous
• dermatofibrosarcoma protuberans (DFSP)
• parotid gland
• and superficial parotidectomy

References

1. Shea CR, Prieto VG. Fibrous lesions of dermis and soft tissue In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, et al, eds. Dermatology in General Medicine. 6th ed. New York: Mc Graw-Hill Company; 2003. p. 996-997.
2. Kovarik CL, Hsu MY, Cockerell CJ. Neurofibromatous changes in dermatofibrosarcoma protuberans: a potential pitfall in the diagnosis of a serious cutaneous soft tissue neoplasm. J Cutan Pathol 2004; 31: 492-496.
3. Navarro M, Requena C, Febrer I, Marin S, Aliaga A. Dermatofibrosarcoma protuberans with onset in early childhood: a case report. J Eur Acad Dermatol Venereol 2002; 16: 154-155.
4. Junaid TA, Ejeckam GC, Ani AN. Dermatofibrosarcoma protuberans in the parotid gland--a case report. Br J Oral Surg 1975; 12: 29830
5. Lee OJ, Pi DY, Jo DH, Cho KJ, Kim SY, Ro JY. Dermatofibrosarcoma Protuberans of the Parotid Gland: A Case Report The Korean Journal of Pathology 2004; 38: 276-279.
6. Weiss SW, Goldblum JR. Enzinger and Weiss’s soft tissue tumors. 4rd ed. St. Louis: Mosby, 2001. p. 49150
7. Elgart GW, Hanly A, Busso M, Spencer JM. Bednar tumor (pigmented dermatofibrosarcoma protuberans) occurring in a site of prior immunization: immunochemical findings and therapy. J Am Acad Dermatol 1999; 40: 315-317.
8. Rutgers EJ, Kroon BB, Albus-Lutter CE, Gortzak E. Dermatofibrosarcoma protuberans: treatment and prognosis. Eur J Surg Oncol 1992; 18: 241-248.

9. Chang CK, Jacobs IA, Salti GI. Outcomes of surgery for dermatofibrosarcoma protuberans. Eur J Surg Oncol 2004; 30: 341-345.
10. Bowne WB, Antonescu CR, Leung DH, et al. Dermatofibrosarcoma protuberans: A clinicopathologic analysis of patients treated and followed at a single institution. Cancer 2000; 88: 2711-2720.
11. Mendenhall WM, Zlotecki RA, Scarborough MT. Dermatofibrosarcoma protuberans. Cancer 2004; 101: 2503-2508.
12. Klijanienko J, Caillaud JM, Lagacé R. Fine-needle aspiration of primary and recurrent dermatofibrosarcoma protuberans. Diagn Cytopathol 2004; 30: 261-265.
13. McArthur GA, Demetri GD, van Oosterom A, et al. Molecular and clinical analysis of locally advanced dermatofibrosarcoma protuberans treated with imatinib: Imatinib Target Exploration Consortium Study B2225. J Clin Oncol 2005; 23: 866-873.
14. Mc Peak CJ. Cruz T, Nicastri AD. Dermatofibrosarcoma protuberans- An analysis of 86 cases-Five with metastasis. Ann Surg 1967; 166: 8038
15. Stojadinovic A, Karpoff HM, Antonescu CR, et al. Dermatofibrosarcoma protuberans of the head and neck. Ann Surg Oncol 2000; 7: 696-704.
16. Paradisi A, Abeni D, Rusciani A, et al. Dermatofibrosarcoma protuberans: wide local excision vs. Mohs micrographic surgery. Cancer Treat Rev 2008; 34: 728-736.
17. Dagan R, Morris CG, Zlotecki RA, Scarborough MT, Mendenhall WM. Radiotherapy in the treatment of dermatofibrosarcoma protuberans. Am J Clin Oncol 2005; 28: 537-539.
18. Ballo MT, Zagars GK, Pisters P, Pollack A. The role of radiation therapy in the management of dermatofibrosarcoma protuberans. Int J Radiat Oncol Biol Phys 1998; 40: 823-827.