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Choi ME, Lee M, Lee WJ, Won CH, Chang SE, Lee MW. Clinical and histopathological analysis of 141 dermatofibrosarcoma protuberans in Korea: A comparative study according to trauma. Australas J Dermatol 2022; 63:e297-e304. [PMID: 36066015 DOI: 10.1111/ajd.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dermatofibrosarcoma protuberans (DFSP) is a rare fibrohistiocytic tumour of unknown pathogenesis with intermediate malignant potential. Although trauma has been hypothesized as a predisposing factor for DFSP development, clinicopathological characteristics of trauma-related DFSP have not been investigated. OBJECTIVE This study investigated the differences between trauma-associated DFSP and trauma-unrelated DFSP. METHODS Patients histopathologically diagnosed with DFSP from January 2000 to December 2019 at the Dermatology Department were included. Clinical, histopathological, prognostic features and trauma history were analysed. RESULTS We recruited 141 patients with DFSP (mean age, 36.1 years; male: female, 1:1.01). Recurrence and systemic metastasis were observed in 15.6% and 2.8% of patients, respectively. Older patients were likely to develop DFSP at the trauma sites more frequently on the face and lower legs. The active-growing lesions were more frequently associated with trauma-related DFSP. Multivariable logistic regression revealed that age at diagnosis (OR: 1.031; 95% CI: 1.004-1.059; p = 0.024) and tumour growth (OR: 3.336; 95% CI: 1.162-9.578, p = 0.025) were significantly associated with trauma-related DFSPs. CONCLUSIONS The age at diagnosis, lesion location and tumour growth were associated with DFSPs in this study. Analysis of DFSP with trauma history provides a deeper understanding of long-term trauma effects on sarcoma development.
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Affiliation(s)
- Myoung Eun Choi
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Miyoung Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Agrawal N, Handa U, Bhagat R, Gupta S. Fine needle aspiration cytology of dermatofibrosarcoma protuberans arising in a burn scar. Cytopathology 2021; 33:266-268. [PMID: 34689359 DOI: 10.1111/cyt.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/12/2021] [Accepted: 10/16/2021] [Indexed: 11/29/2022]
Abstract
Tumours developing after a protracted period of time in burn scars are a notable complication with carcinomas forming a major share. The occurrence of burn scar sarcomas is scarce with dermatofibrosarcoma protuberans (DFSP) being an uncommon entity having only three prior reported cases. Herein we report a case of a 32-year-old male patient with a 5 year prior history of thermal burn who presented with an expanding painless swelling for 2 years in the right flank region, diagnosed as DFSP on fine needle aspiration cytology and subsequently confirmed on histopathology.
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Affiliation(s)
- Nandini Agrawal
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Uma Handa
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Ranjeev Bhagat
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Sanjay Gupta
- Department of General Surgery, Government Medical College and Hospital, Chandigarh, India
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3
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Burusapat C, Wanichjaroen N, Wongprakob N, Satayasoontorn K. Characteristics of Marjolin's Ulcers in 21st Century: A Retrospective Study, Systematic Review, and Surgical Guideline Recommendation. J Burn Care Res 2020; 42:152-166. [PMID: 33128365 DOI: 10.1093/jbcr/iraa196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Marjolin's ulcer is rare and aggressive malignancy. The objective was to conduct a review of Marjolin's ulcer cases to gain a better understanding and its management. A retrospective study of patients with Marjolin's ulcers at our hospital between 2010 and 2019 was conducted. For the systematic review, the electronic database of the National Library of Medicine was searched and articles published between 2000 and 2019 were included. A total of 14 patients were included in the retrospective study. Twelve patients were male. The mean age was 59.71 years. The latency period was 27.78 years. The most common malignancy was squamous cell carcinoma, and 71.43% had developed on the lower extremities. Well-differentiated squamous cell carcinomas occurred in 38.46% of the cases Rates of lymphovascular and perineural invasion were 30.77 and 23.08%, respectively. Results from the literature search yielded 80 case reports (91 cases) and 42 retrospective reviews (1216 cases). Most cases were male and the most common location was lower extremities. The latency period for the acute and chronic periods was 2.75 months and 20.75 years, respectively. The most common malignancy was squamous cell carcinoma (92.27% in the retrospective reviews) and 59.98% of the cases exhibited well-differentiation. Rates of regional lymph node involvement and distant metastases were 10.20 and 12.09%, respectively. Marjolin's ulcer in 21st century is not so rare. The most common is well differentiated squamous cell carcinoma. Early flap surgery or skin grafts for chronic ulcers or burn scars are recommended to reduce risk. Guideline for surgical management is established.
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Affiliation(s)
- Chairat Burusapat
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Nutthapong Wanichjaroen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Nuttadon Wongprakob
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Kantang Satayasoontorn
- Department of Pathology and Laboratory Medicine, Phramongkutklao Hospital, Bangkok, Thailand
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4
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Haghayeghi K, Dicomo JA, Edmonson D, Banet N. Dermatofibrosarcoma protuberans with fibrosarcomatous transformation arising at the site of breast implant. Breast J 2020; 26:1811-1813. [PMID: 32223026 DOI: 10.1111/tbj.13823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/10/2020] [Indexed: 11/30/2022]
Abstract
Fibrosarcomatous transformation of dermatofibrosarcoma protuberans (DFSP) is a rare variant with higher risk of recurrence and metastasis, and no known associations with breast implants. We report a rare case of fibrosarcomatous dermatofibrosarcoma protuberans arising at the site of breast implant in a 33-year-old patient followed by brief discussion on fibrosarcomatous DFSP.
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Affiliation(s)
- Koorosh Haghayeghi
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Joseph A Dicomo
- Department of General Surgery, Rhode Island Hospital and Lifespan Cancer Center, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - David Edmonson
- Department of General Surgery, Rhode Island Hospital and Lifespan Cancer Center, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Natalie Banet
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
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6
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Lee SW, Zaesim A, Jackson A, Borkat M. Fibrosarcomatous dermatofibrosarcoma protuberans from scar following trauma. AUTOPSY AND CASE REPORTS 2019; 8:e2018039. [PMID: 30775318 PMCID: PMC6360829 DOI: 10.4322/acr.2018.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/19/2018] [Indexed: 01/01/2023] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue neoplasm of low metastatic potential notable for its progressive growth and high rate of local recurrence after surgical excision. Fibrosarcomatous transformation of DFSP (FS-DFSP) is a rare variant characterized by higher rates of local recurrence and metastasis. Trauma has been hypothesized as a potential risk factor for the development of DFSP, although clear evidence has been lacking. In this study, we report a case of FS-DFSP that was found arising from a previously stable scar following a traumatic injury. A 49-year-old male was diagnosed with keloid scars following a motor vehicle accident where he sustained trauma. 12 years later, a large tumor developed immediately after a second traumatic event to the primary scar. Pathology of the excisional biopsy specimen demonstrated FS-DFSP with focal areas consistent with keloid and hypertrophic scar. This observation demonstrates the development of DFSP from underlying scar following a clear history of trauma. Furthermore, it suggests trauma as a possible trigger for the fibrosarcomatous transformation of DFSP.
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Affiliation(s)
- Sang Wook Lee
- Mercer University School of Medicine. Columbus, GA, United States of America
| | - Araya Zaesim
- Mercer University School of Medicine. Columbus, GA, United States of America
| | - Amanda Jackson
- Mercer University School of Medicine. Columbus, GA, United States of America
| | - Michael Borkat
- Mercer University School of Medicine. Columbus, GA, United States of America.,St. Francis Center for Surgical Care. Columbus, GA, United States of America
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7
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Dermatofibrosarcoma Protuberans: an Update and Review. CURRENT DERMATOLOGY REPORTS 2015. [DOI: 10.1007/s13671-015-0120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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8
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Valdivielso-Ramos M, Torrelo A, Campos M, Feito M, Gamo R, Rodriguez-Peralto JL. Pediatric dermatofibrosarcoma protuberans in Madrid, Spain: multi-institutional outcomes. Pediatr Dermatol 2014; 31:676-82. [PMID: 25424208 DOI: 10.1111/pde.12371] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Little is known about the incidence and management of dermatofibrosarcoma protuberans (DFSP) in children. We conducted a retrospective review of all patients younger than 18 years of age treated for DFSP over a period of 11 years (2000-2011) in Madrid, Spain. The sample consisted of 13 children. The average annual incidence of DFSP in the pediatric population corresponded to 1.02 cases per million person-years (95% confidence interval 0.55, 1.73). Sites of involvement were diverse, with 15.3% of tumors found in acral locations. The median tumor size was 3.5 cm × 3 cm and the median time from apparent onset to diagnosis was 36 months. Histopathologic examination revealed conventional (77.0%), pigmented (15.4%), and myxoid (7.6%) variants. The mitotic index was consistently <5 per 10 high-power fields. All lesions were removed using surgical excision. One patient developed a local recurrence because of initial affected margins; none developed metastases. The median duration of clinical follow-up was 70.5 months. This study estimated the average annual incidence rate of DFSP in a population of patients younger than 18 years and reviewed the experience of several hospitals in the management of this tumor.
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9
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Singh N, Rao S, Jain S. Post-burn duct carcinoma breast: An unusual case report. J Cytol 2013; 30:139-41. [PMID: 23833406 PMCID: PMC3701340 DOI: 10.4103/0970-9371.112660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Malignancies arising from burn scars though rare are well documented in the literature; squamous cell carcinoma is the most common burn scar neoplasm, and adenocarcinoma is an extremely uncommon and rarely reported tumor in these scars. We hereby report a case of a young woman who presented with a rapidly growing lump in a scar in the mammary region that sustained severe burns 20 years back. It was diagnosed as duct carcinoma breast on cytology and later confirmed on histopathology and immunohistochemistry. The case mandates regular follow-up of patients with post-burn scars, and any lump arising in that region should be promptly investigated.
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Affiliation(s)
- Neha Singh
- Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, India
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10
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Valdivielso-Ramos M, Hernanz JM. Dermatofibrosarcoma protuberans in childhood. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:863-73. [PMID: 23154247 DOI: 10.1016/j.adengl.2011.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 12/25/2011] [Indexed: 11/24/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a fibrohistiocytic tumor of intermediate malignancy that is very rare in childhood. Only 6% of these tumors present in children. Clinical diagnosis is very difficult in the early stages of disease, but to ensure appropriate treatment it is important to identify DFSP as early as possible and rule out benign conditions that are more common at this age. The clinical presentation and histopathologic and molecular characteristics of DFSP are similar in children and adults. Clinical diagnosis is, however, more difficult in children and requires a high degree of suspicion. The absence of characteristic features and the rarity of this tumor explain why diagnosis is often delayed. Complete surgical excision of the tumor is very important to reduce the risk of recurrence. This article presents a review of current knowledge about the management of DFSP in children and examines the latest treatment options.
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Stivala A, Lombardo GAG, Pompili G, Tarico MS, Fraggetta F, Perrotta RE. Dermatofibrosarcoma protuberans: Our experience of 59 cases. Oncol Lett 2012; 4:1047-1055. [PMID: 23162649 DOI: 10.3892/ol.2012.887] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 05/11/2012] [Indexed: 11/05/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue tumor with intermediate malignancy. It is initially located on the skin from where it is able to infiltrate the deep structures and has a tendency to recur locally following inadequate excision. A t(17;22)(q22;q13) chromosome trans-location is the main cytogenetic alteration responsible for the onset of DFSP. Treatment options include complete surgical excision by performing conventional surgery with wide margins (>3 cm) or Mohs micrographic surgery. A retrospective study was conducted in our Department of Plastic and Reconstructive Surgery and all data were collected from medical records of 59 DFSP patients within this department from 1999 to 2011. A total of 13 of 59 (22%) cases were treated with conventional excision; 3 (5%) cases resulted in tumor-free margins, 8 (14%) cases required surgical revision and 2 (3%) cases lead to recurrence. A total of 46 of 59 (78%) cases were treated with wide excision; 43 (73%) cases resulted in tumor-free margins, 3 (5%) cases required surgical revision and 0 (0%) cases lead to recurrence. In conclusion, the data collected reveal the controversy surrounding the adoption of general guidelines regarding safe margins. Further studies are required to investigate the possibility of obtaining genotypically altered margins from margins that may appear phenotypically healthy.
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Affiliation(s)
- Alessio Stivala
- Department of Medical and Surgery Specialties, Section of Plastic Surgery
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12
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Valdivielso-Ramos M, Hernanz JM. Dermatofibrosarcoma Protuberans in Childhood. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:863-873. [PMID: 22482741 DOI: 10.1016/j.ad.2011.12.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 12/23/2011] [Accepted: 12/25/2011] [Indexed: 11/30/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a fibrohistiocytic tumor of intermediate malignancy that is very rare in childhood. Only 6% of these tumors present in children. Clinical diagnosis is very difficult in the early stages of disease, but to ensure appropriate treatment it is important to identify DFSP as early as possible and rule out benign conditions that are more common at this age. The clinical presentation and histopathologic and molecular characteristics of DFSP are similar in children and adults. Clinical diagnosis is, however, more difficult in children and requires a high degree of suspicion. The absence of characteristic features and the rarity of this tumor explain why diagnosis is often delayed. Complete surgical excision of the tumor is very important to reduce the risk of recurrence. This article presents a review of current knowledge about the management of DFSP in children and examines the latest treatment options.
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13
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14
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Seo JK, Cho KJ, Kang JH, Lee D, Sung HS, Hwang SW. Dermatofibrosarcoma protuberans arising from a burn scar. Ann Dermatol 2009; 21:416-8. [PMID: 20523837 DOI: 10.5021/ad.2009.21.4.416] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 04/21/2009] [Accepted: 05/15/2009] [Indexed: 11/08/2022] Open
Abstract
Malignant neoplasms arising in burn scars are well known. In previous literature, 25 cases of burn scar sarcomas were reported. However, dermatofibrosarcoma protuberans is very rare and only two cases have been reported. A 43-year-old Korean man presented with multiple erythematous clustered plaques and nodules and a skin-colored subcutaneous mass on the chest after a severe burn injury at the age of 8 years. A biopsy specimen revealed dermatofibrosarcoma protuberans. The tumor was excised widely to include the surrounding burn scar. Herein, we report this third case of dermatofibrosarcoma protuberans arising from a burn scar.
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Affiliation(s)
- Jong Keun Seo
- Department of Dermatology, Inje University School of Medicine, Busan, Korea
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Jafarian F, McCuaig C, Kokta V, Laberge L, Ben Nejma B. Dermatofibrosarcoma protuberans in childhood and adolescence: report of eight patients. Pediatr Dermatol 2008; 25:317-25. [PMID: 18577035 DOI: 10.1111/j.1525-1470.2008.00674.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We reviewed all occurrences of dermatofibrosarcoma protuberans in children under 17 years of age who were evaluated at Sainte-Justine Hospital, a tertiary-care pediatric center, between 1980 and 2002. The medical records and histologic features of all were reviewed. Eight patients were identified, three boys and five girls. The interval between apparent onset and diagnosis ranged from 3 months to 14 years. All lesions except one were removed by surgical excision with a margin of 1.5 to 3 cm including underlying fascia or by Mohs technique. Follow-up ranged from 2 to 15 years with median of 5 years. To date all the patients are alive and none has had a recurrence.
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Affiliation(s)
- Fatemeh Jafarian
- Division of Dermatology, Department of Pediatrics, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, Canada
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Sanmartín O, Llombart B, López-Guerrero JA, Serra C, Requena C, Guillén C. Dermatofibrosarcoma protuberans. ACTAS DERMO-SIFILIOGRAFICAS 2007; 98:77-87. [PMID: 17397592 DOI: 10.1016/s0001-7310(07)70019-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a soft tissue neoplasm of intermediate malignancy that is initially localized to the skin from where it can invade deep structures (fat, fascia, muscle and bone). It is the most frequent fibrohistiocytic tumor, comprising approximately 1.8 % of all soft tissue sarcomas and 0.1 % of all cancers. It has an estimated incidence of 0.8-5 cases per one million persons per year. Treatment of localized disease consists in complete surgical excision of the lesion by conventional surgery with wide margins (>3 cm) or by micrographic Mohs surgery. Although the cases of metastatic DFSP do not reach 5 % of the total, almost all of them appear after previous local relapses. The prognosis for metastatic cases is very poor with a survival of less than 2 years following detection of metastatic disease. Patients with locally advanced DFSP are not candidates for an initial radical surgical therapy therefore neoadyuvant treatment is required prior to surgery in order to reduce tumor burden. In this regard, chemotherapy and radiotherapy have not been highly efficacious so it is necessary to consider new alternatives. The demonstration of the oncogenic power of the translocation COL1A1-PDGFB in DFSP has allowed the successful introduction of drug therapy with antagonists of the PDGFB receptor for metastatic or locally advanced cases.
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MESH Headings
- Antigens, CD34/analysis
- Antineoplastic Agents/therapeutic use
- Benzamides
- Biomarkers, Tumor/analysis
- Chemotherapy, Adjuvant
- Chromosomes, Human, Pair 17/ultrastructure
- Chromosomes, Human, Pair 22/genetics
- Chromosomes, Human, Pair 22/ultrastructure
- Combined Modality Therapy
- Dermatofibrosarcoma/chemistry
- Dermatofibrosarcoma/classification
- Dermatofibrosarcoma/drug therapy
- Dermatofibrosarcoma/genetics
- Dermatofibrosarcoma/pathology
- Dermatofibrosarcoma/surgery
- Drug Design
- Humans
- Imatinib Mesylate
- Mohs Surgery
- Neoadjuvant Therapy
- Neoplasm Invasiveness
- Neoplasm Proteins/analysis
- Neoplasm Proteins/genetics
- Neoplasm Recurrence, Local
- Oncogene Proteins, Fusion/analysis
- Oncogene Proteins, Fusion/genetics
- Piperazines/therapeutic use
- Prognosis
- Pyrimidines/therapeutic use
- Receptor, Platelet-Derived Growth Factor beta/antagonists & inhibitors
- Ring Chromosomes
- Sarcoma/chemistry
- Sarcoma/drug therapy
- Sarcoma/genetics
- Sarcoma/pathology
- Sarcoma/surgery
- Skin Neoplasms/chemistry
- Skin Neoplasms/drug therapy
- Skin Neoplasms/genetics
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Translocation, Genetic
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Affiliation(s)
- O Sanmartín
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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18
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Andersen F, Andersen K, Kligman A. Efficacy of an Aluminum Oxide Scrub Cream in the Treatment of Xerotic Skin of the Elderly. ACTA ACUST UNITED AC 2005. [DOI: 10.1159/000085573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Kowal-Vern A, Criswell BK. Burn scar neoplasms: a literature review and statistical analysis. Burns 2005; 31:403-13. [PMID: 15896501 DOI: 10.1016/j.burns.2005.02.015] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Accepted: 02/21/2005] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although squamous cell carcinoma (SCC) is the most common burn scar neoplasm, other neoplasms have also been reported. OBJECTIVE To compile the burn scar neoplasm cases in the literature and to analyze their frequency and demographic characteristics. MATERIALS AND METHODS Cases were obtained through literature searches. RESULTS There were 412 cases gleaned from 146 articles between 1923 and 2004. Seventy-one percent (293) of the tumors were squamous cell carcinoma, 12% (48) were basal cell carcinoma (BCC), 6% (23) were melanoma, 5% (21) were sarcoma, 4% (16) were other neoplasms, 1% (6) were squamo-basal cell carcinoma, and 1% (5) squamous cell-melanoma. The mean age at tumor diagnosis was 50 years, the mean age at the time of burn injury was 20 years, the mean latency interval was 31 years. Only 5% of the reported cases were excised and grafted at the time of injury (p<0.001). BCC occurred at a significantly later age compared to SCC and sarcoma groups (p<0.02) and had a shorter latency period compared to SCC and sarcoma groups (p<0.004) and melanoma (p<0.008). Local recurrence was present in 16% of the cases, while regional lymph node involvement was seen in 22% of the cases and distant metastases was present in 14% of the patients. The mortality rate was 21%. CONCLUSIONS Although the main burn scar neoplasm was SCC, other neoplasms contributed to the morbidity and mortality of burn patients. Excision and grafting of deep burns, and close follow-up of non-healing ulcerated burn scars is essential for the prevention and early detection of burn scar neoplasms.
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Affiliation(s)
- Areta Kowal-Vern
- Sumner L. Koch Burn Center, Department of Trauma, John H. Stroger, Jr. Hospital of Cook County, 1901 West Harrison Street, Room 3229, Chicago, IL 60612, USA.
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