[Outcome of locally advanced Darier and Ferrand dermatofibrosarcoma: about a case and literature review]

Dermatofibrosarcoma protuberans surgery: Experiences of four African surgical oncology units and literature review

BACKGROUND AND OBJECTIVES

Dermatofibrosarcoma is a locally malignant tumor. This gives surgery a place of choice. The advent of imatinib has improved outcomes. Our aim is to describe the indications, techniques and results of surgery.

METHODS

A retrospective, multicenter, descriptive study conducted in four West African surgical oncology units. It covers dermatofibrosarcoma surgery performed between January 1, 1988 and December 31, 2020. We took into account the surgical procedure, the mode of skin coverage, adjuvant treatments and survival. Comparisons were possible using Student's t-test and Pearson's χ² .

RESULTS

We recorded 81 cases of dermatofibrosarcoma. Surgery was effective in 90.1% of cases. Wide resection was the principle with a mean resection margin of 3.8 ± 1.9 cm. healing by primary intention, flaps and healing by secondary intention were the methods of skin coverage in 30.1%, 24.7% and 41.1% respectively. The type of skin coverage was related to the topography and size of the tumor (p < 0.0001). The healing time is associated with the type of skin cover. The recurrence rate was not related to the type of skin coverage (p = 0.8).

CONCLUSIONS

Wide and deep resection in the absence of Mohs micrographic surgery ensures healthy margins. Oncoplasty reduces the healing time without increasing the risk of recurrence.

[Dermatofibrosarcoma protuberans (Darier-Ferrand) of the abdomen: a case report]

Dermatofibrosarcoma is a rare skin tumor. Morphological characteristics can be misleading and unknown to most of physicians. Diagnostic delay may affect patient´s management and prognosis. We here report the case of a young patient with lesions protruding from the abdominal wall mistaken for benign cysts. X-ray examination revealed subcutaneous adipose tissue mass. This was suspected of being a fibrosarcoma. The mass was resected with a macroscopic safety margin. The anatomo-pathological study confirmed the diagnosis of dermatofibrosarcoma. Clinical and radiological follow-up examinations didn´t show any recurrence. This study highlights the importance of suspecting this rare tumor requiring specialist treatment.