Fibrohistiozytäre Tumoren der Haut: Eine heterogene Gruppe oberflächlich lokalisierter mesenchymaler Neoplasien

Multiple benign fibrous histiocytomas of the mandible: A case report and review of the literature

Benign fibrous histiocytoma (BFH) mostly occurs on the skin of the extremities, while it is unusual to manifest on the bone and mandibular involvement of BFH is even rarer. The present study reports a case of BFH in a 42-year-old female who had a slowly progressive swelling of the bilateral mandible and slight facial asymmetry over a period of 4 months. However, the outcome of this patient was unsatisfactory, with the first and second recurrence observed 16 and 46 months after surgery, respectively. The present case suggests that BFH has a risk of recurrence after transoral curettage. Regular follow-up is advised to detect tumor recurrence after the surgery of transoral curettage.

Dermatofibrosarcoma protuberans of the hallux: A case report with review of the literature

INTRODUCTION AND IMPORTANCE

Darier-Ferrand dermatofibrosarcoma (DFS) is a rare mesenchymal tumor with an aggressive local behavior, high local recurrence frequency and low metastatic potential. It commonly presents as a raised slowly growing mass. It usually occurs on trunk and proximal extremities but rarely touches distal extremities such as hands, fingers, or foot below knees.

CASE PRESENTATION

A 15-year-old girl presents with a protuberant painful mass of the right hallux of 2 years. After surgical excision, histological examination revealed a spindle shaped cells with a strong CD34 expression and the diagnosis of Darier-Ferrand dermatofibrosarcoma of the toe was confirmed. We proceeded to a review of the literature of Dermatofibrosarcoma on the toes with the aim to reveal, its clinical presentations, histopathology, and treatment options.

CLINICAL DISCUSSION

DFS represents 0.1 % of all cancers. It is a low-grade sarcoma with a locally aggressive behavior and a low metastatic potential. Only 11 cases of DFS of the toes have been reported in the literature. It usually occurs in the trunk, and proximal extremities. Histological and immunohistochemical examination are mandatory to confirm the diagnosis with diffuse expression of CD34 by the tumoral cells. Surgery is the standard treatment for localized and resectable lesions.

CONCLUSION

Darier-Ferrand Dermatofibrosarcoma is an uncommon and recurrent dreadful tumor, that rarely occurs on toes, but should be considered in front of persistent slowly growing foot lesions.

Dermatofibrosarcoma protuberans in a young patient with epidermolysis bullosa: a case report

Background

Epidermolysis bullosa is a group of rare inherited skin diseases characterized by blister formation following mechanical skin trauma. Epidermolysis bullosa is associated with increased skin cancer rates, predominantly squamous cell carcinomas, yet to our best knowledge, there is no reported case of dermatofibrosarcoma protuberans in a patient with Epidermolysis bullosa.

Case presentation

Here, we present a 26-year-old man with junctional epidermolysis bullosa, who developed a DFSP on the neck. Initial, the skin alteration was mistakenly not considered malignant, which resulted in inadequate safety margins. The complete resection required a local flap to close the defect, which is not unproblematic because of the chronic inflammation and impaired healing potential of the skin due to Epidermolysis bullosa.

Conclusions

To our best knowledge, this is the first reported case of a skin-associated sarcoma in a patient with EB; however, further investigation is required to verify a correlation.

S1 guidelines for dermatofibrosarcoma protuberans (DFSP) - update 2018

While dermatofibrosarcoma protuberans (DFSP) is a rare cancer entity overall, it is nevertheless the most common type of cutaneous sarcoma. The tumor is of fibroblastic origin and characterized by slow, undermining and locally destructive growth. Metastatic spread is very rare. Given its nonspecific clinical appearance, diagnosis is frequently delayed. Biopsy and subsequent histopathology are key diagnostic tools. Standard treatment for primary tumors consists of complete excision with surgical margins of 1 to 2 cm. Smaller margins are associated with high local recurrence rates. Inoperable and metastatic DFSP may be treated with radiation therapy. Approximately 80-90 % of DFSP lesions harbor a fusion gene that results in continuous activation of the PDGF-β signaling pathway. Consequently, molecular targeted therapy inhibiting PDGF-β is an effective option for advanced (inoperable) and metastatic DFSP. The first agent to be approved for systemic treatment of DFSP is the multikinase inhibitor imatinib, showing objective response rates of about 50 % in clinical trials.

Aneurysmal fibrous histiocytoma

Aneurysmal fibrous histiocytoma (AFH) is a type of fibrohistiocytic tumour. We present a case of a patient who presented with a skin papule on the thigh region. Histopathological examination following total excision of the lesion revealed an AFH. No sign of recurrence was present 6 months after surgery.