Brodawczakowłókniak kosmówkowy – Charakterystyka, pielęgnacja i opieka

Brodawczakowłókniak kosmówkowy
Charakterystyka, pielęgnacja i opieka

Brodawczakowłókniak kosmówkowy (DFSP) to rzadki, wolno rosnący mięsak tkanki miękkiej, wywodzący się z fibroblastów skóry właściwej, najczęściej lokalizujący się na tułowiu i proksymalnych częściach kończyn. Charakteryzuje się infiltracyjnym wzrostem i wysokim ryzykiem miejscowych nawrotów, przy rzadkich przerzutach odległych. Diagnostyka opiera się na biopsji skóry oraz badaniach obrazowych (CT, MRI) w celu oceny zasięgu guza. Leczenie z wyboru stanowi chirurgia mikrograficzna Mohsa (MMS), która umożliwia precyzyjne usunięcie guza z oceną 100% marginesów, osiągając wskaźnik wyleczenia około 93,4% i minimalizując ryzyko nawrotów (1,3%). Alternatywnie stosuje się szerokie wycięcie miejscowe (WLE) z marginesem 2-3 cm, jednak z wyższym ryzykiem nawrotów (15,7% na tułowiu, 51,8% na głowie i szyi). W przypadku dodatnich marginesów lub choroby nieoperacyjnej zalecana jest radioterapia uzupełniająca (dawka 50-70 Gy) oraz terapia systemowa imatynibem (800 mg/dobę), szczególnie w przypadkach nawrotowych, przerzutowych lub nieoperacyjnych, z około 65% wskaźnikiem odpowiedzi na leczenie.

Wprowadzenie do brodawczakowłókniaka kosmówkowego

Brodawczakowłókniak kosmówkowy (Dermatofibrosarcoma protuberans, DFSP) jest rzadkim, wolno rosnącym nowotworem tkanki miękkiej, który wywodzi się z komórek fibroblastycznych skóry właściwej. Ten typ mięsaka występuje najczęściej na tułowiu i proksymalnych częściach kończyn, zazwyczaj w postaci wolno rozwijającej się, twardej zmiany o zabarwieniu czerwono-fioletowym lub niebieskim¹². DFSP charakteryzuje się wysoką skłonnością do miejscowych nawrotów, natomiast rzadko daje przerzuty odległe. Szacuje się, że w Stanach Zjednoczonych rocznie diagnozuje się około 1500 nowych przypadków tego nowotworu³. Choroba ta dotyka najczęściej pacjentów w wieku 20-50 lat⁴.

DFSP wymaga szczególnej uwagi ze strony personelu medycznego ze względu na infiltracyjny charakter wzrostu, który często powoduje, że granice kliniczne guza są trudne do określenia, co przekłada się na wysokie ryzyko nieadekwatnego wycięcia i nawrotu choroby⁵. Guzy DFSP często rozrastają się głęboko w otaczające tkanki tłuszczowe, mięśnie, a w rzadkich przypadkach również kość, co stanowi dodatkowe wyzwanie w leczeniu⁶.

Diagnostyka i ocena DFSP

Dokładna diagnostyka ma kluczowe znaczenie dla efektywnego leczenia DFSP. Proces diagnostyczny zazwyczaj obejmuje następujące elementy:

Badanie fizykalne i wstępna ocena

Lekarz dermatolog przeprowadza dokładne badanie skóry pacjenta. W przypadku podejrzenia DFSP, niezbędne jest wykonanie biopsji skóry, która stanowi jedyną metodę pozwalającą na postawienie jednoznacznego rozpoznania⁷. Biopsja może być bezpiecznie przeprowadzona przez dermatologa w warunkach ambulatoryjnych.

Badania obrazowe

W celu określenia zasięgu guza i oceny głębokości inwazji, lekarze mogą zlecić badania obrazowe, takie jak tomografia komputerowa (CT) lub rezonans magnetyczny (MRI). Badania te są szczególnie istotne przed planowaną interwencją chirurgiczną, ponieważ pozwalają na ocenę zaangażowania głębszych struktur⁸⁹.

Ocena multidyscyplinarna

Ze względu na złożoność przypadków DFSP, szczególnie ważne jest omówienie przypadku pacjenta na konferencji wielodyscyplinarnej, co pozwala na stworzenie indywidualnego planu leczenia. Specjaliści z różnych dziedzin, w tym dermatologii, chirurgii onkologicznej, radioterapii i onkologii medycznej, współpracują, aby zapewnić optymalne podejście terapeutyczne¹⁰.

Leczenie chirurgiczne DFSP

Leczenie chirurgiczne pozostaje podstawową metodą terapii DFSP. Ze względu na charakter wzrostu guza, który często wykracza poza granice kliniczne, kluczowe jest całkowite usunięcie nowotworu z odpowiednim marginesem tkanek zdrowych¹¹.

Chirurgia mikrograficzna Mohsa

Chirurgia mikrograficzna Mohsa (MMS) jest obecnie preferowaną metodą leczenia DFSP. Technika ta polega na stopniowym, warstwowym usuwaniu tkanek z natychmiastową oceną mikroskopową zamrożonych skrawków¹²¹³. MMS umożliwia dokładną ocenę 100% marginesów chirurgicznych, co pozwala na:

Maksymalne zachowanie zdrowej tkanki
Lepszą kontrolę trójwymiarowych marginesów guza
Znacząco niższy odsetek nawrotów w porównaniu do tradycyjnego szerokiego wycięcia

¹⁴¹⁵

Badania wskazują, że chirurgia mikrograficzna Mohsa osiąga wskaźnik wyleczenia na poziomie około 93,4% po pierwszym zabiegu i charakteryzuje się niskim odsetkiem nawrotów, co czyni ją metodą z wyboru w leczeniu DFSP¹⁶.

Szerokie wycięcie miejscowe

Szerokie wycięcie miejscowe (WLE) jest alternatywną metodą chirurgiczną, stosowaną gdy MMS nie jest dostępna. Technika ta polega na wycięciu guza z szerokim marginesem zdrowych tkanek, zazwyczaj 2-3 cm, aż do powięzi włącznie¹⁷¹⁸.

Badania wykazały, że ryzyko nawrotu miejscowego przy marginesie resekcji mniejszym niż 3 cm wynosi 47%, w porównaniu do 7% przy marginesach 3-5 cm¹⁹²⁰. Pomimo szerokiego wycięcia, średni odsetek nawrotów wynosi ok. 15,7% dla zmian zlokalizowanych na tułowiu i 51,8% dla zmian w obrębie głowy i szyi, co podkreśla przewagę techniki Mohsa, gdzie średni wskaźnik nawrotów wynosi zaledwie 1,3%²¹.

Rekonstrukcja po zabiegu

Ze względu na rozległy charakter wycięcia, wielu pacjentów wymaga rekonstrukcji po usunięciu guza DFSP. W zależności od lokalizacji i wielkości ubytku, stosowane są różne techniki rekonstrukcyjne:

Płaty miejscowe – wykorzystane w większości przypadków
Przeszczepy skóry pośredniej grubości
Płaty mięśniowo-skórne, takie jak płat z mięśnia najszerszego grzbietu
Uszypułowane płaty powięziowo-skórne, np. z przednio-bocznej części uda

²²²³

Rekonstrukcję najlepiej przeprowadzić po potwierdzeniu, że wszystkie marginesy są wolne od nowotworu, co może wymagać odroczenia zabiegu rekonstrukcyjnego do czasu pełnej oceny histopatologicznej²⁴.

Terapie uzupełniające w leczeniu DFSP

W niektórych przypadkach, szczególnie gdy margines chirurgiczny jest niewystarczający lub gdy guz jest nieoperacyjny, stosuje się terapie uzupełniające.

Radioterapia

DFSP jest nowotworem wrażliwym na promieniowanie. Radioterapia rzadko jest stosowana jako jedyna metoda leczenia, ale ma istotne znaczenie jako terapia uzupełniająca²⁵. Zgodnie z aktualnymi wytycznymi NCCN, radioterapię uzupełniającą zaleca się w następujących sytuacjach:

Dodatnie marginesy po resekcji chirurgicznej
Marginesy ujemne, ale mniejsze niż 1 cm u pacjentów, którzy nie przeszli MMS
Choroba nawrotowa lub przerzutowa, gdy resekcja chirurgiczna nie jest możliwa

²⁶²⁷

Całkowita dawka promieniowania zazwyczaj wynosi 50-70 Gy²⁸. Badania wykazały, że radioterapia może poprawić wskaźnik kontroli miejscowej w porównaniu do samej chirurgii w wybranych przypadkach²⁹.

Terapia celowana – Imatynib

Imatynib (Gleevec) jest doustnym inhibitorem kinazy tyrozynowej, który został zatwierdzony przez FDA do leczenia DFSP. Jest wskazany dla dorosłych pacjentów z nieoperacyjnym, nawrotowym i/lub przerzutowym DFSP³⁰. Zalecana dawka doustna wynosi 800 mg/dobę.

Imatynib może być stosowany w następujących sytuacjach:

Przed operacją (terapia neoadjuwantowa) – w celu zmniejszenia guza i ułatwienia resekcji
W przypadku choroby nieoperacyjnej
Przy nawrocie po zabiegu chirurgicznym
W przypadku choroby przerzutowej

³¹³²³³

Dotychczasowe dane kliniczne wskazują na wskaźnik odpowiedzi wynoszący około 65% wśród pacjentów z DFSP leczonych imatynibem. Należy jednak zauważyć, że niewielka podgrupa pacjentów z DFSP, u których brak klasycznej aberracji genu t(17,22), wydaje się nie odpowiadać na leczenie imatynibem³⁴.

Stosowanie imatynibu jako terapii przedoperacyjnej w zaawansowanym lub nawrotowym DFSP może zmniejszyć masę guza, promować apoptozę komórek nowotworowych i w konsekwencji ograniczyć zakres operacji³⁵. Jest to szczególnie istotne w przypadkach, gdy guz jest zbyt duży lub trudny do chirurgicznego usunięcia³⁶.

Opieka pooperacyjna i monitorowanie

Ze względu na wysoki wskaźnik nawrotów miejscowych DFSP, pacjenci wymagają starannej obserwacji po leczeniu³⁷.

Schemat obserwacji

Większość nawrotów występuje w ciągu pierwszych 3 lat po pierwotnym wycięciu. Zaleca się następujący harmonogram kontroli:

Wizyty kontrolne co 6 miesięcy przez pierwsze 3-5 lat
Następnie wizyty roczne

³⁸³⁹⁴⁰

Warto zauważyć, że 50% nawrotów pojawia się w ciągu pierwszych 3 lat po operacji, a 25% miejscowych nawrotów jest wykrywanych po 5 latach. Ze względu na powolny charakter DFSP, konieczny jest dożywotni nadzór pod kątem nawrotu⁴¹.

Elementy wizyty kontrolnej

Podczas każdej wizyty kontrolnej należy przeprowadzić:

Pełny wywiad i przegląd układów
Kompletne badanie fizykalne, w tym badanie skóry
Badanie palpacyjne miejsca wycięcia i regionalnych węzłów chłonnych
W razie potrzeby – badania obrazowe

⁴²

Pacjenci powinni być również edukowani w zakresie samokontroli i natychmiastowego zgłaszania wszelkich niepokojących zmian w okolicy blizny, takich jak nowe guzki, które nie ustępują w ciągu 1-2 tygodni⁴³.

Podejście multidyscyplinarne w opiece nad pacjentem z DFSP

Skuteczne leczenie DFSP wymaga współpracy specjalistów z różnych dziedzin medycyny⁴⁴⁴⁵.

Zespół multidyscyplinarny

W skład zespołu zajmującego się pacjentem z DFSP powinni wchodzić:

Dermatolog – specjalista w zakresie diagnostyki wstępnej i biopsji
Chirurg onkologiczny lub dermatolog-chirurg Mohsa – do przeprowadzenia zabiegu operacyjnego
Chirurg plastyczny – w celu wykonania rekonstrukcji po wycięciu
Radioterapeuta – w przypadku konieczności zastosowania radioterapii uzupełniającej
Onkolog kliniczny – do nadzorowania terapii systemowej (imatynib)
Pielęgniarka onkologiczna – do koordynacji opieki i edukacji pacjenta

⁴⁶⁴⁷

Takie podejście zapewnia kompleksową opiekę i optymalne wyniki leczenia przy jednoczesnym minimalizowaniu ryzyka nawrotu miejscowego oraz efektywnym leczeniu choroby zaawansowanej lub przerzutowej⁴⁸.

Rola personelu pielęgniarskiego w opiece nad pacjentem z DFSP

Personel pielęgniarski odgrywa kluczową rolę w opiece nad pacjentem z DFSP, obejmującą:

Edukację pacjenta na temat choroby i dostępnych opcji leczenia
Przygotowanie pacjenta do zabiegu chirurgicznego
Opiekę pooperacyjną, w tym monitorowanie miejsca operacji pod kątem powikłań
Nauczanie pacjenta technik samokontroli w celu wczesnego wykrywania nawrotu
Koordynację wizyt kontrolnych i badań diagnostycznych
Wsparcie psychologiczne dla pacjenta i jego rodziny
Monitorowanie działań niepożądanych terapii uzupełniających (radioterapia, imatynib)

⁴⁹⁵⁰

Kompleksowa edukacja pacjenta i proaktywne strategie zapobiegawcze mogą pomóc pacjentom w aktywnym udziale w dbaniu o własne zdrowie skóry oraz ułatwić wczesne wykrycie i leczenie ewentualnego nawrotu DFSP⁵¹⁵².

Wyzwania w leczeniu DFSP

Leczenie DFSP wiąże się z pewnymi wyzwaniami, które mogą wpływać na wyniki terapii:

Problemy związane z resekcją

Jedną z głównych trudności w leczeniu DFSP jest nieregularny charakter wzrostu guza, który często wykracza poza granice kliniczne. To może prowadzić do:

Nieadekwatnej początkowej resekcji – prawie 50% pacjentów doświadcza nawrotu miejscowego po prostym wycięciu⁵³
Konieczności wielokrotnych resekcji – 22% pacjentów wymaga co najmniej jednej ponownej resekcji⁵⁴
Trudności w osiągnięciu ujemnych marginesów – pomimo planowanych marginesów 1,0 cm w 67,4% przypadków, tylko 69,0% pacjentów osiąga resekcję R0 przy pierwszym zabiegu⁵⁵

Badania wskazują, że marginesy R0 przy pierwszej resekcji są związane z szerszymi marginesami obwodowymi i nieobecnością histologii typu włókniakomięsaka⁵⁶.

Szczególne lokalizacje anatomiczne

DFSP zlokalizowany w niektórych regionach anatomicznych stanowi dodatkowe wyzwanie:

Głowa i szyja – wysoki wskaźnik nawrotów (51,8%) po standardowym wycięciu⁵⁷
Okolice „stref niebezpiecznych” dla nerwu twarzowego – ryzyko uszkodzenia struktur nerwowo-naczyniowych⁵⁸
Pierś – trudność diagnostyczna ze względu na podobieństwo do innych łagodnych i złośliwych zmian piersi⁵⁹

W takich przypadkach szczególnie zalecane jest multidyscyplinarne podejście terapeutyczne⁶⁰.

Innowacyjne podejścia w leczeniu DFSP

W ostatnich latach rozwijane są nowe techniki i podejścia w leczeniu DFSP, mające na celu poprawę wyników terapeutycznych i zmniejszenie powikłań.

Technika „Saturnowych Pierścieni”

Jest to nowatorska technika chirurgiczna, która łączy zalety szerokiego wycięcia miejscowego i chirurgii Mohsa. Metoda ta uwzględnia zarówno szerokość, jak i głębokość resekcji, co jest kluczowe ze względu na inwazyjny charakter DFSP. W badaniu obejmującym 29 pacjentów z DFSP tułowia lub kończyn, nie zaobserwowano nawrotów w okresie obserwacji wynoszącym co najmniej 9 miesięcy. Technika ta zmniejsza obciążenie fizyczne i psychiczne zarówno pacjenta, jak i chirurga, a także daje korzystne wyniki kosmetyczne⁶¹.

Mniejsze marginesy resekcji

Najnowsze badania sugerują, że w niektórych przypadkach możliwe jest osiągnięcie ujemnych marginesów przy mniejszej resekcji. Tak długo, jak osiągnięty jest ujemny margines, usunięto wystarczającą ilość tkanki, co może prowadzić do mniejszej liczby działań niepożądanych, lepszego efektu kosmetycznego i lepszych wyników funkcjonalnych dla pacjenta⁶².

Podsumowanie i zalecenia praktyczne

DFSP stanowi istotne wyzwanie kliniczne ze względu na swoją tendencję do miejscowej inwazji i wysokiego odsetka nawrotów po nieadekwatnym leczeniu. Kluczowe zalecenia dla personelu medycznego obejmują:

Dokładną diagnostykę z wykorzystaniem biopsji i odpowiednich badań obrazowych
Preferowanie chirurgii mikrograficznej Mohsa jako metody z wyboru, zapewniającej najniższy odsetek nawrotów
W przypadku braku dostępu do MMS – szerokie wycięcie miejscowe z marginesem co najmniej 2-3 cm
Rozważenie terapii uzupełniającej (radioterapia, imatynib) w przypadku dodatnich marginesów lub choroby nieoperacyjnej
Systematyczne monitorowanie pacjentów po leczeniu przez co najmniej 5 lat, a najlepiej dożywotnio
Multidyscyplinarne podejście do leczenia z udziałem specjalistów z różnych dziedzin
Kompleksową edukację pacjenta na temat choroby, leczenia i konieczności samokontroli

Personel pielęgniarski odgrywa kluczową rolę w opiece nad pacjentem z DFSP, zapewniając edukację, wsparcie psychologiczne i koordynację złożonego procesu terapeutycznego. Wczesne rozpoznanie i odpowiednie leczenie są kluczowe dla osiągnięcia optymalnych wyników terapeutycznych i zapewnienia pacjentowi jak najlepszej jakości życia⁶³⁶⁴.

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Materiały źródłowe

#1 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Dermatofibrosarcoma protuberans (DFSP) stands as a rare soft tissue sarcoma that emerges in the dermis and is often found on the trunk and proximal extremities. This condition can present as a slowly developing, robust plaque, exhibiting shades of pink or violet, underscoring the challenge of timely diagnosis. Surgical excision, whether through Mohs micrographic surgery or wide local excision, remains the cornerstone of treatment. However, the potential for local recurrence necessitates vigilant monitoring posttreatment, with radiation therapy sometimes employed to mitigate this risk. Emerging treatments such as tyrosine kinase inhibitors show promise in managing advanced or metastatic disease, highlighting the evolving landscape of DFSP management. […] Healthcare professionals engaging in this comprehensive course on DFSP gain invaluable insights into its pathophysiology, clinical presentation, evaluation, and management.
#2 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma primarily found on the trunk and proximal extremities that typically appears as a slowly progressing, firm, violet-red, or blue plaque. […] Surgical excision with clear margins is the preferred treatment, utilizing techniques like Mohs micrographic surgery or wide local excision. […] Patients require vigilant monitoring for local recurrence following curative treatment. […] The initial treatment for localized DFSP is surgical resection with negative margins. […] The risk of inadequate initial resection is high due to the delay in diagnosis and the tumor’s ability to invade surrounding tissues. […] Nearly 50% of patients will experience local recurrence with simple excision. […] For these reasons, pathological negative margins are necessary.
#3 Dermatofibrosarcoma Protuberans, Version 1.2025, NCCN Clinical Practice Guidelines In Oncology – PubMed
https://pubmed.ncbi.nlm.nih.gov/39819674/
Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous soft tissue sarcoma and affects an estimated 1,500 people annually in the United States. DFSP frequently exhibits extensive local infiltration. Initial treatment is through surgical excision, and care should be taken to ensure that negative margins are achieved to minimize recurrence. […] Although DFSP has a reported high rate of recurrence, metastasis is more uncommon. Fibrosarcomatous DFSP is an aggressive variant with an increased risk for local recurrence and metastasis. If achieving negative margins or resection is not feasible, radiation therapy or systemic treatment are options that may be considered by a multidisciplinary team. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) outline recommended treatment options available for DFSP.
#4
https://tumorsurgery.org/tumor-education/soft-tissue-tumors/soft-tissue-tumor-types/dermatofibrosarcoma-protuberans-dfsp.aspx
Dermatofibrosarcoma Protuberans (DFSP) is an infrequent type of malignant skin sarcoma. It arises from the dermis of the skin. DFSP accounts for less than 6% of all soft tissue sarcomas. There are approximately 1000 cases in the United States yearly (3 cases per million yearly). This type of tumor most commonly affects patients between 20 and 50 years old. The most common location for DFSP is around the torso (50%), but is also seen on the legs, arms, neck and head. Dermatofibrosarcoma Protuberans grows slowly and starts as a flatness or depression in the skin. Commonly is described as a reddish or purplish patch in the skin. Although this tumor is located in the skin DFSP tends to grow deeply into the surrounding fat, muscle and rarely bone. […] The mainstay therapy for DFSP is the wide resection of the tumor. It has a tendency to recur in the same location after it is removed.
#5 Dermatofibrosarcoma protuberans: Treatment – UpToDate
https://www.uptodate.com/contents/dermatofibrosarcoma-protuberans-treatment
Dermatofibrosarcoma protuberans (DFSP) is an uncommon locally aggressive cutaneous soft tissue sarcoma. Approximately 85 to 90 percent of DFSPs are low grade, while the remainder contain a high-grade sarcomatous component (which is usually a fibrosarcoma, designated DFSP-FS) and are considered to be intermediate-grade sarcomas. Although they rarely metastasize (fewer than 5 percent of cases), all DFSP variants have a propensity to recur locally. […] The preferred initial treatment for a localized dermatofibrosarcoma protuberans (DFSP) is resection with pathologically negative margins. Tumor size and location dictate the most appropriate surgical procedure. Given that metastases to lymph nodes are extremely rare, there is no role for prophylactic regional node dissection. […] One of the characteristic features of DFSP is its capacity to invade surrounding tissues in an eccentric fashion to a considerable distance from the central focus of the tumor, with tumor cells invading subcutaneous tissue in the form of irregular tentacle-like projections through the septa and fat lobules. This fact, coupled with the rarity of DFSP and diagnostic delay, often leads to inadequate initial resection. The risk of a local recurrence is as high as 50 percent with simple excision („conservative” surgical margins), and it is even higher if the margins are positive. […] The status of the surgical margins is the most important prognostic factor in patients with DFSP.
#6
https://tumorsurgery.org/tumor-education/soft-tissue-tumors/soft-tissue-tumor-types/dermatofibrosarcoma-protuberans-dfsp.aspx
Dermatofibrosarcoma Protuberans (DFSP) is an infrequent type of malignant skin sarcoma. It arises from the dermis of the skin. DFSP accounts for less than 6% of all soft tissue sarcomas. There are approximately 1000 cases in the United States yearly (3 cases per million yearly). This type of tumor most commonly affects patients between 20 and 50 years old. The most common location for DFSP is around the torso (50%), but is also seen on the legs, arms, neck and head. Dermatofibrosarcoma Protuberans grows slowly and starts as a flatness or depression in the skin. Commonly is described as a reddish or purplish patch in the skin. Although this tumor is located in the skin DFSP tends to grow deeply into the surrounding fat, muscle and rarely bone. […] The mainstay therapy for DFSP is the wide resection of the tumor. It has a tendency to recur in the same location after it is removed.
#7 Skin cancer types: Dermatofibrosarcoma protuberans diagnosis & treatment
https://www.aad.org/public/diseases/skin-cancer/types/common/dfsp/treatment
Your dermatologist will closely examine your skin. If your dermatologist suspects you have DFSP, you will need a skin biopsy. This is the only way to diagnose skin cancer. Your dermatologist can safely perform a skin biopsy during an office visit. […] If the diagnosis is DFSP, you will need a thorough physical exam. You may also need some medical tests. These tests provide the information necessary to create a treatment plan for DFSP. […] Most treatment plans include surgery to remove the cancer. Because DFSP can grow deep, other treatment may be necessary. A treatment plan for DFSP usually includes one of more of the following treatments: […] During this surgery, the surgeon removes the tumor(s) and some surrounding tissue that looks healthy. Removing this tissue helps to catch cancer that may have traveled to an area that still looks healthy.
#8 DFSP (Dermatofibrosarcoma Protuberans) | Norton Children’s
https://nortonchildrens.com/services/cancer/conditions/sarcoma/dfsp/
Dermatofibrosarcoma protuberans (DFSP) is a rare tumor that typically appears in young adults. DFSP grows in the skin and the layer of fat just below the skin. […] DFSP has the best chance of being cured when itâs treated by pediatric cancer specialists. Young adults may benefit from treatment at a childrenâs hospital instead of an adult-service hospital because of the care teamâs expertise specifically in childhood diseases. […] A skin biopsy is the most common diagnostic test. A small sample of the lesion is collected and examined by a pathologist under a microscope. Sometimes an MRI scan may be ordered to determine whether any of the lesionâs root-like tentacles have reached deeper than the skin. […] Mohs micrographic surgery is the most common treatment for DFSP. In this procedure, the surgeon will remove one layer of tissue at a time. Each layer is checked for the presence of cancer, and the process is repeated until all affected tissue is removed. […] Traditional surgery to remove the tumor is recommended in some cases. Chemotherapy typically is used only in adults with inoperable, recurring or metastatic DFSP.
#9 Dermatofibrosarcoma Protuberans (DFSP) | Dermatologist | La Porte & Valparaiso, IN |Applegarth Dermatology PC
https://www.applegarthdermatology.com/articles/aad_education_library/920158-dermatofibrosarcoma-protuberans-dfsp/
If you or someone you know has been recently diagnosed with Dermatofibrosarcoma protuberans (DFSP), you may be feeling overwhelmed and scared. Don’t worry; we are here to help. This article will discuss everything you need to know about DFSP, including what it is, how it is treated, and the side effects of treatment. We hope that this information will help put your mind at ease and allow you to face DFSP head-on! […] DFSP is usually diagnosed with a biopsy. During a biopsy, your doctor will remove a small piece of the lump or affected skin and send it to a laboratory for analysis. Your doctor may also order other imaging tests, such as computerized tomography (CT) scan or magnetic resonance imaging (MRI), to help determine the extent of the tumor. […] The most common treatment for DFSP is surgery. Your doctor will remove the tumor and a margin of healthy tissue around it. In some cases, radiation therapy or chemotherapy may be recommended before or after surgery.
#10
https://www.karmanos.org/karmanos-foundation/news/auburn-woman-spots-signs-of-a-lesserknown-cancer-a-3442
I evaluated Susan with imaging tests to check and be sure that the sarcoma had not spread to other organs, like the lungs or liver, explained Dr. Oyasiji. Together, with other cancer experts, her case was discussed with scientific evidence at our multidisciplinary conference to curate a treatment plan that is unique to her and the kind of cancer she had. […] Following surgery, my expertise also comes into play, together with my colleagues – medical and radiation oncologists – to determine if she needed radiation or chemotherapy after surgery. Fortunately for Susan, she did not require these additional treatments. She continues surveillance on 3-6 monthly basis with interval imaging tests to closely monitor and be sure that the sarcoma does not come back. If it ever does come back, well quickly swing into action and treat it. […] Susan had an excellent recovery after surgery, said Dr. Oyasiji. She continues to do very well and enjoy life to the fullest. I am so happy that our team was able to help her on her journey to beat cancer.
#11 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Moreover, the course equips learners with proficiency in employing various treatment modalities, including surgical techniques like Mohs micrographic surgery and wide local excision. […] By integrating multidisciplinary approaches, healthcare providers optimize patient outcomes by minimizing the risk of local recurrence and addressing advanced or metastatic disease more effectively. […] The initial treatment for localized DFSP is surgical resection with negative margins. […] The risk of inadequate initial resection is high due to the delay in diagnosis and the tumor’s ability to invade surrounding tissues. […] For these reasons, pathological negative margins are necessary. […] Wide local excision (WLE) is an option for resection. […] Results from one study reveal the local recurrence in patients with a resection margin less than 3 cm is 47% compared to 7% in patients with margins of 3 to 5 cm.
#12 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible. […] Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] To enhance patient-centered care, outcomes, patient safety, and team performance related to DFSP, physicians, advanced practice practitioners, nurses, pharmacists, and other healthcare professionals must collaborate effectively using a multidisciplinary approach.
#13 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Because of its infiltrating growth pattern, DFSP commonly extends far beyond the clinical margins; this accounts in part for the high recurrence rate after standard surgical excision. Hence, a wide excision of 2-3 cm or more of the margins beyond clinically identifiable tumor border, down to and including the fascia, is recommended for the treatment of DFSP. […] Despite wide local excisions, an average recurrence rate of 15.7% is still observed among 1201 body cases and 51.8% is observed among 193 head and neck cases, as reported in the literature since 1951. A superior cure rate (an overall average recurrence rate of 1.3% among 463 cases reported) and tissue conservation are seen when Mohs micrographic surgery is used; thus, Mohs micrographic surgery is now considered the treatment of choice, particularly when a lesion is located in the head and neck region.
#14 Dermatofibrosarcoma protuberans of the breast: A case study
https://www.spandidos-publications.com/10.3892/mco.2021.2212
The exact margin of resection is still unknown, but due to histologically tumour-free margins varying significantly from clinically-free ones, an excision with no less than 2-3 cm with skin, subcutaneous tissue and fascia included is wide accepted. […] Mohs Micrographic Surgery allows the extent of excision to be customized to the microscopic extent of tumour and results in better tridimensional margin control. […] In a series of 29 patients, this technique resulted in 93.4% cure rate after the first surgery and low recurrence rates at least short-term. […] As a result, MMS is currently advised as the method of choice for the treatment of DFSP. […] However, MMS has yet to be widely diffused and many centers-including ours-use as a primary mode of treatment standard surgical techniques (WLE) and histopathological procedures.
#15 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Because of its infiltrating growth pattern, DFSP commonly extends far beyond the clinical margins; this accounts in part for the high recurrence rate after standard surgical excision. Hence, a wide excision of 2-3 cm or more of the margins beyond clinically identifiable tumor border, down to and including the fascia, is recommended for the treatment of DFSP. […] Despite wide local excisions, an average recurrence rate of 15.7% is still observed among 1201 body cases and 51.8% is observed among 193 head and neck cases, as reported in the literature since 1951. A superior cure rate (an overall average recurrence rate of 1.3% among 463 cases reported) and tissue conservation are seen when Mohs micrographic surgery is used; thus, Mohs micrographic surgery is now considered the treatment of choice, particularly when a lesion is located in the head and neck region.
#16 Dermatofibrosarcoma protuberans of the breast: A case study
https://www.spandidos-publications.com/10.3892/mco.2021.2212
The exact margin of resection is still unknown, but due to histologically tumour-free margins varying significantly from clinically-free ones, an excision with no less than 2-3 cm with skin, subcutaneous tissue and fascia included is wide accepted. […] Mohs Micrographic Surgery allows the extent of excision to be customized to the microscopic extent of tumour and results in better tridimensional margin control. […] In a series of 29 patients, this technique resulted in 93.4% cure rate after the first surgery and low recurrence rates at least short-term. […] As a result, MMS is currently advised as the method of choice for the treatment of DFSP. […] However, MMS has yet to be widely diffused and many centers-including ours-use as a primary mode of treatment standard surgical techniques (WLE) and histopathological procedures.
#17 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Wide local excision (WLE) is an option for resection. […] Results from one study reveal the local recurrence in patients with a resection margin less than 3 cm is 47% compared to 7% in patients with margins of 3 to 5 cm. […] Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] DFSP is radiosensitive tumor. Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible.
#18 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Because of its infiltrating growth pattern, DFSP commonly extends far beyond the clinical margins; this accounts in part for the high recurrence rate after standard surgical excision. Hence, a wide excision of 2-3 cm or more of the margins beyond clinically identifiable tumor border, down to and including the fascia, is recommended for the treatment of DFSP. […] Despite wide local excisions, an average recurrence rate of 15.7% is still observed among 1201 body cases and 51.8% is observed among 193 head and neck cases, as reported in the literature since 1951. A superior cure rate (an overall average recurrence rate of 1.3% among 463 cases reported) and tissue conservation are seen when Mohs micrographic surgery is used; thus, Mohs micrographic surgery is now considered the treatment of choice, particularly when a lesion is located in the head and neck region.
#19 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Moreover, the course equips learners with proficiency in employing various treatment modalities, including surgical techniques like Mohs micrographic surgery and wide local excision. […] By integrating multidisciplinary approaches, healthcare providers optimize patient outcomes by minimizing the risk of local recurrence and addressing advanced or metastatic disease more effectively. […] The initial treatment for localized DFSP is surgical resection with negative margins. […] The risk of inadequate initial resection is high due to the delay in diagnosis and the tumor’s ability to invade surrounding tissues. […] For these reasons, pathological negative margins are necessary. […] Wide local excision (WLE) is an option for resection. […] Results from one study reveal the local recurrence in patients with a resection margin less than 3 cm is 47% compared to 7% in patients with margins of 3 to 5 cm.
#20 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Wide local excision (WLE) is an option for resection. […] Results from one study reveal the local recurrence in patients with a resection margin less than 3 cm is 47% compared to 7% in patients with margins of 3 to 5 cm. […] Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] DFSP is radiosensitive tumor. Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible.
#21 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Because of its infiltrating growth pattern, DFSP commonly extends far beyond the clinical margins; this accounts in part for the high recurrence rate after standard surgical excision. Hence, a wide excision of 2-3 cm or more of the margins beyond clinically identifiable tumor border, down to and including the fascia, is recommended for the treatment of DFSP. […] Despite wide local excisions, an average recurrence rate of 15.7% is still observed among 1201 body cases and 51.8% is observed among 193 head and neck cases, as reported in the literature since 1951. A superior cure rate (an overall average recurrence rate of 1.3% among 463 cases reported) and tissue conservation are seen when Mohs micrographic surgery is used; thus, Mohs micrographic surgery is now considered the treatment of choice, particularly when a lesion is located in the head and neck region.
#22
https://journals.lww.com/md-journal/fulltext/2023/11170/effective_resection_of_dermatofibrosarcoma.87.aspx
Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade sarcoma with locally infiltrative characteristics. A wide excision is made with a 5cm gross margin. However, recently, Mohs micrographic surgery has emerged as an alternative. […] This method secures a negative margin after frozen biopsy at regular intervals of circumference and depth. […] Therefore, we would like to share our novel surgical technique through this article. […] The depth of the excision initially extended to the fascia, including the layer that was primarily invaded, according to visual inspection. […] Reconstruction of the defect after tumor removal involved a local flap in 24 cases, a split-thickness skin graft in 8 cases, a latissimus dorsi musculocutaneous flap in 2 cases, and a pedicled anterolateral thigh fasciocutaneous flap in 1 case.
#23 Dermatofibrosarcoma Protuberans: Symptoms and Treatment
https://www.foxchase.org/blog/2013-12-06-what-dermatofibrosarcoma-protuberans-dfsp-and-how-it-treated
Dermatofibrosarcoma protuberans (DFSP) are rare tumors of the deeper layer of the skin that can be aggressive in the location where they arise but rarely metastasize (spread to other organs). […] After a diagnosis it is important to see a physician that has experience with these rare tumors. […] Some options for removal include an excision in the operating room by a surgeon or possibly using a technique called Mohs surgery performed by a dermatologist. […] Depending on where the DFSP is located some patients require reconstruction at the excision site by a plastic surgeon with either a skin graft or flap. […] Despite frequent prolonged delays in diagnosis, the chance of distant spread is very low with a rate of less than 24 percent. […] However, the local recurrence rate (the chance of it coming back) of DFSP has been reported to be as high as 50 percent within three years in some series. […] We published a series demonstrating very low rates of recurrence using a multidisciplinary approach with careful analysis of the margins. […] Although it is very rare, we sometimes recommend radiation or chemotherapy after surgery, especially in patients with recurrence of the DFSP.
#24 Dermatofibrosarcoma Protuberans: Update on the Diagnosis and Treatment
https://www.mdpi.com/2077-0383/9/6/1752
The standard treatment of resectable DFSPs is complete surgical excision with either wide local excision with tumor free margins or Mohs micrographic surgery, or, rarely, amputation. Each procedure has advantages and drawbacks. Unresectable DFSPs are treated with radiation therapy and/or targeted therapy. […] Surgical excision is the standard treatment of DFSP including stage I and II, even III and IV whenever feasible. Wide undermining following surgical excision is not advisable as it may seed tumor in incomplete resections and also may cause difficulty in interpreting subsequent re-excisions. Initial resected tumors with positive margins or relapsed/recurrent tumors need to be further resected to achieve wide clear margins whenever possible. Surgical reconstruction should be delayed until all margins are confirmed negative by complete peripheral and deep margin examination.
#25 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Wide local excision (WLE) is an option for resection. […] Results from one study reveal the local recurrence in patients with a resection margin less than 3 cm is 47% compared to 7% in patients with margins of 3 to 5 cm. […] Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] DFSP is radiosensitive tumor. Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible.
#26 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible. […] Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] To enhance patient-centered care, outcomes, patient safety, and team performance related to DFSP, physicians, advanced practice practitioners, nurses, pharmacists, and other healthcare professionals must collaborate effectively using a multidisciplinary approach.
#27 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Wide local excision (WLE) is an option for resection. […] Results from one study reveal the local recurrence in patients with a resection margin less than 3 cm is 47% compared to 7% in patients with margins of 3 to 5 cm. […] Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] DFSP is radiosensitive tumor. Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible.
#28
https://www.orthobullets.com/pathology/8066/dermatofibrosarcoma-protuberans
Dermatofibrosarcoma Protuberans are rare, low-grade fibrogenic cutaneous sarcomas that occur in early to mid-adult life. […] Treatment is usually wide surgical resection with radiation therapy. […] Nonoperative treatment includes imatinib, which inhibits PDGF-receptor tyrosine kinase, indicated for adult patients with unresectable, recurrent, and/or metastatic DFSP. […] Operative treatment involves wide surgical resection with or without adjuvant radiation therapy, particularly for patients with resectable DFSP. […] Adjuvant radiation therapy is useful in patients with positive margins or in whom adequate wide excision alone may result in major cosmetic or functional deficits. […] Clean margins are an important goal of surgical resection, with a recommendation to obtain 2-3cm margins and to dissect deep to and excise all tissue including the fascia. […] Total dose of radiation therapy is 50-70 Gy. […] Local recurrence is common, and worse prognosis is seen with regional lymph node involvement and fibrosarcomatous progression DFSP variant.
#29 Status Report on the Management of Dermatofibrosarcoma Protuberans: Is There a Viable Role for the Use of Imatinib Mesylate? In Which Cases May It Be Therapeutically Helpful and in Which Cases Not? | JCAD – The Journal of Clinical and Aesthetic Dermatolog
https://jcadonline.com/status-report-on-the-management-of-dermatofibrosarcoma-protuberans-is-there-a-viable-role-for-the-use-of-imatinib-mesylate-in-which-cases-may-it-be-therapeutically-helpful-and-in-which-cases-not/
As DFSP is radiosensitive, radiation therapy has been used for primary or locally recurrent DFSP, usually as preoperative or postoperative adjuvant therapy. […] Overall, radiation therapy has been shown to improve local control rate as compared to surgery alone in selected cases; however, the total number of tabulated patients undergoing combined treatment with both surgery and radiation therapy is relatively low. […] Imatinib mesylate, an orally administered tyrosine kinase breakpoint cluster region-abetalipoproteinemia (BCR-ABL) inhibitor, which also affects ABL-related kinase, KIT, platelet-derived growth factor beta (PDGFbeta), and PDGF receptor-alpha, has been very effectively used to treat gastrointestinal (GI) stromal tumors (GISTs) and chronic myelogenous leukemia. […] Imatinib can also be used as adjuvant therapy to prevent relapses in children, but it has not been shown definitively to be effective.
#30 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Surgical excision remains the mainstay of treatment. Mohs micrographic surgery or other forms of peripheral and deep en face margin assessment (PDEMA) is the treatment of choice. Wide excision can be considered if PDEMA is unavailable. Radiation therapy may be administered if margins are positive and further resection is not feasible or following wide excision if margins are considered narrow. […] In cases of recurrence, repeated resection is preferred. Radiotherapy is an alternative if not previous given or if resection is not feasible. When the disease is unresectable, treatment with imatinib can be considered. […] On October 19, 2006, the US Food and Drug Administration granted approval for imatinib mesylate (Gleevec) as a single agent for the treatment of DFSP. Imatinib mesylate is indicated for the treatment of adult patients with unresectable, recurrent, and/or metastatic DFSP. The recommended oral dose is 800 mg/d. NCCN guidelines recommend imatinib be considered for recurrent unresectable disease.
#31 Dermatofibrosarcoma Protuberans (DFSP): Causes & Treatment
https://my.clevelandclinic.org/health/diseases/24068-dermatofibrosarcoma-protuberans
Dermatofibrosarcoma protuberans (DFSP) is a rare type of skin cancer that starts in your skins middle layer (the dermis). This cancer grows slowly and rarely spreads. But it can return after surgical treatment. Dermatologists perform Mohs surgery to treat DFSP. […] Surgical removal is the treatment of choice for DFSP. Dermatologists perform Mohs surgery to remove DFSP tumors. During the procedure, your provider injects a local anesthetic into the treatment area to numb it. […] Healthcare providers use imatinib to treat metastatic DFSP or tumors that are too large or difficult to surgically remove. Imatinib can also shrink the tumor, making surgical removal possible. […] Dermatofibrosarcoma protuberans (DFSP) is a rare skin cancer thats unlikely to spread. Still, you need surgical treatment to keep the tumors from spreading. A prompt diagnosis and treatment are critical to improving your outlook.
#32 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Surgical excision remains the mainstay of treatment. Mohs micrographic surgery or other forms of peripheral and deep en face margin assessment (PDEMA) is the treatment of choice. Wide excision can be considered if PDEMA is unavailable. Radiation therapy may be administered if margins are positive and further resection is not feasible or following wide excision if margins are considered narrow. […] In cases of recurrence, repeated resection is preferred. Radiotherapy is an alternative if not previous given or if resection is not feasible. When the disease is unresectable, treatment with imatinib can be considered. […] On October 19, 2006, the US Food and Drug Administration granted approval for imatinib mesylate (Gleevec) as a single agent for the treatment of DFSP. Imatinib mesylate is indicated for the treatment of adult patients with unresectable, recurrent, and/or metastatic DFSP. The recommended oral dose is 800 mg/d. NCCN guidelines recommend imatinib be considered for recurrent unresectable disease.
#33 Dermatofibrosarcoma Protuberans, Version 1.2025, NCCN Clinical Practice Guidelines In Oncology in: Journal of the National Comprehensive Cancer Network Volume 23 Issue 1 (2025)
https://jnccn.org/abstract/journals/jnccn/23/1/article-e250001.xml
Given the historically high local recurrence rates for DFSP, ongoing clinical follow-up with focus on the primary site every 6 to 12 months is indicated, with rebiopsy of any suspicious regions. […] Imatinib mesylate should be considered in cases where the disease is unresectable after multiple resections, or if unacceptable functional or cosmetic outcomes will occur with further resection.
#34 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
With limited clinical data to date, a response rate of approximately 65% has been achieved among DFSP patients treated with imatinib. A small subset of DFSP patients lacking the classic t(17,22) gene aberration seems to have no response to imatinib. […] Neoadjuvant imatinib therapy for DFSP has been proposed. Using imatinib as a preoperative therapy agent in locally advanced or recurrent DFSP may decrease tumor load, promote tumor cell apoptosis, and subsequently reduce the extent of surgery. […] Radiation therapy may be recommended for patients if the margins of resection are positive or for situations in which adequate wide excision alone may result in major cosmetic or functional deficits. Postoperative adjuvant RT may reduce the risk of recurrence when clear surgical margins are not confident.
#35 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
With limited clinical data to date, a response rate of approximately 65% has been achieved among DFSP patients treated with imatinib. A small subset of DFSP patients lacking the classic t(17,22) gene aberration seems to have no response to imatinib. […] Neoadjuvant imatinib therapy for DFSP has been proposed. Using imatinib as a preoperative therapy agent in locally advanced or recurrent DFSP may decrease tumor load, promote tumor cell apoptosis, and subsequently reduce the extent of surgery. […] Radiation therapy may be recommended for patients if the margins of resection are positive or for situations in which adequate wide excision alone may result in major cosmetic or functional deficits. Postoperative adjuvant RT may reduce the risk of recurrence when clear surgical margins are not confident.
#36 Dermatofibrosarcoma Protuberans (DFSP): Causes & Treatment
https://my.clevelandclinic.org/health/diseases/24068-dermatofibrosarcoma-protuberans
Dermatofibrosarcoma protuberans (DFSP) is a rare type of skin cancer that starts in your skins middle layer (the dermis). This cancer grows slowly and rarely spreads. But it can return after surgical treatment. Dermatologists perform Mohs surgery to treat DFSP. […] Surgical removal is the treatment of choice for DFSP. Dermatologists perform Mohs surgery to remove DFSP tumors. During the procedure, your provider injects a local anesthetic into the treatment area to numb it. […] Healthcare providers use imatinib to treat metastatic DFSP or tumors that are too large or difficult to surgically remove. Imatinib can also shrink the tumor, making surgical removal possible. […] Dermatofibrosarcoma protuberans (DFSP) is a rare skin cancer thats unlikely to spread. Still, you need surgical treatment to keep the tumors from spreading. A prompt diagnosis and treatment are critical to improving your outlook.
#37 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Studies have demonstrated a low recurrence rate after surgery for DFSP if a multidisciplinary approach and careful pathology margin assessment are used. […] Because of the high local recurrence rate of dermatofibrosarcoma protuberans (DFSP), patients require close follow-up care after treatment. Most recurrences occur within 3 years of the primary excision. Patients should be seen every 6 months during this period and annually thereafter. […] A literature review of DFSP case series treated with Mohs surgery shows that 50% of recurrences appear within the first 3 years after operation and 25% of local recurrences are detected after 5 years. The indolent nature of DFSP requires lifelong surveillance for recurrence. […] In each follow-up visit, a complete history and a review of systems, as well as complete physical examinations, including skin examination and palpation of the excision site and regional lymph nodes, should be performed.
#38 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Studies have demonstrated a low recurrence rate after surgery for DFSP if a multidisciplinary approach and careful pathology margin assessment are used. […] Because of the high local recurrence rate of dermatofibrosarcoma protuberans (DFSP), patients require close follow-up care after treatment. Most recurrences occur within 3 years of the primary excision. Patients should be seen every 6 months during this period and annually thereafter. […] A literature review of DFSP case series treated with Mohs surgery shows that 50% of recurrences appear within the first 3 years after operation and 25% of local recurrences are detected after 5 years. The indolent nature of DFSP requires lifelong surveillance for recurrence. […] In each follow-up visit, a complete history and a review of systems, as well as complete physical examinations, including skin examination and palpation of the excision site and regional lymph nodes, should be performed.
#39 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] Healthcare professionals caring for patients with DFSP must be proficient in recognizing the characteristics of DFSP and accurately interpreting diagnostic tests such as biopsies and imaging studies. […] Developing a comprehensive care plan tailored to each patient’s unique needs is essential. […] Patients require vigilant monitoring for local recurrence posttreatment.
#40 Dermatofibrosarcoma protuberans
https://dermnetnz.org/topics/dermatofibrosarcoma-protuberans
Dermatofibrosarcoma protuberans is an uncommon skin tumour arising in the deeper layer of the skin (the dermis). It grows slowly but has a tendency to recur after excision. Luckily, it rarely spreads to other sites beyond the skin. […] Treatment of dermatofibrosarcoma protuberans and dermatofibrosarcoma protuberans with fibrosarcomatous transformation consists of wide excision of the lesion including deep fascia, with 13 cm margin of normal skin. It may take more than one surgical procedure to ensure complete removal of a tumour. […] Follow-up with clinical examination of the site of the dermatofibrosarcoma protuberans is recommended every 6 months for 5 years, and then annually.
#41 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Studies have demonstrated a low recurrence rate after surgery for DFSP if a multidisciplinary approach and careful pathology margin assessment are used. […] Because of the high local recurrence rate of dermatofibrosarcoma protuberans (DFSP), patients require close follow-up care after treatment. Most recurrences occur within 3 years of the primary excision. Patients should be seen every 6 months during this period and annually thereafter. […] A literature review of DFSP case series treated with Mohs surgery shows that 50% of recurrences appear within the first 3 years after operation and 25% of local recurrences are detected after 5 years. The indolent nature of DFSP requires lifelong surveillance for recurrence. […] In each follow-up visit, a complete history and a review of systems, as well as complete physical examinations, including skin examination and palpation of the excision site and regional lymph nodes, should be performed.
#42 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Studies have demonstrated a low recurrence rate after surgery for DFSP if a multidisciplinary approach and careful pathology margin assessment are used. […] Because of the high local recurrence rate of dermatofibrosarcoma protuberans (DFSP), patients require close follow-up care after treatment. Most recurrences occur within 3 years of the primary excision. Patients should be seen every 6 months during this period and annually thereafter. […] A literature review of DFSP case series treated with Mohs surgery shows that 50% of recurrences appear within the first 3 years after operation and 25% of local recurrences are detected after 5 years. The indolent nature of DFSP requires lifelong surveillance for recurrence. […] In each follow-up visit, a complete history and a review of systems, as well as complete physical examinations, including skin examination and palpation of the excision site and regional lymph nodes, should be performed.
#43 Dermatofibrosarcoma protuberans (DFSP) – BAD Patient Hub
https://www.skinhealthinfo.org.uk/condition/dermatofibrosarcoma-protuberans-dfsp/
DFSP is treated by surgical excision (removal). There are two main types of surgery: […] Wide excision this involves removal of the DFSP with a margin of normal skin around the edges. […] Mohs micrographic surgery this is a type of surgery in which the surgeon tries to spare skin, done under local anaesthetic. […] Very rarely, DFSP may spread to other parts of the body. Further treatment may then be required, such as radiotherapy or drugs. […] Imatinib is a chemotherapy medicine used for DFSP that cannot be removed with an operation or has spread within the body (a metastatic DFSP). […] DFSP can be difficult even for doctors to detect. After having had a DFSP, you should do regular checks of your scar at home; if you notice any changes in the scar, such as new lumps which do not settle within a week or two, you should contact your primary care physician, dermatologist or department leading your care.
#44 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible. […] Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] To enhance patient-centered care, outcomes, patient safety, and team performance related to DFSP, physicians, advanced practice practitioners, nurses, pharmacists, and other healthcare professionals must collaborate effectively using a multidisciplinary approach.
#45 Surgical and Functional Considerations of Dermatofibrosarcoma Protuberans Involving Facial Nerve Danger Zones | JCAD – The Journal of Clinical and Aesthetic Dermatology
https://jcadonline.com/dermatofibrosarcoma-danger-zones-december-2019/
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive tumor, uncommonly occurring on the head and neck where these deeply infiltrating tumors might violate underlying neurovascular structures. Treatment is typically surgical, whether by Mohs micrographic surgery (MMS) or wide local excision (WLE). […] The proper assessment and reporting of postoperative functional recovery should be undertaken following facial DFSP resection and consideration should be given to a multidisciplinary treatment approach. […] A multidisciplinary approach between dermatologic surgeons and otolaryngology-head and neck surgeons, as well as intraoperative Mohs micrographic surgery, could be beneficial in treating these patients. Further reporting, ideally with standardized metrics, of facial nerve injury and neurologic outcomes is needed to better counsel potential future surgical candidates.
#46
https://www.karmanos.org/karmanos-foundation/news/auburn-woman-spots-signs-of-a-lesserknown-cancer-a-3442
I evaluated Susan with imaging tests to check and be sure that the sarcoma had not spread to other organs, like the lungs or liver, explained Dr. Oyasiji. Together, with other cancer experts, her case was discussed with scientific evidence at our multidisciplinary conference to curate a treatment plan that is unique to her and the kind of cancer she had. […] Following surgery, my expertise also comes into play, together with my colleagues – medical and radiation oncologists – to determine if she needed radiation or chemotherapy after surgery. Fortunately for Susan, she did not require these additional treatments. She continues surveillance on 3-6 monthly basis with interval imaging tests to closely monitor and be sure that the sarcoma does not come back. If it ever does come back, well quickly swing into action and treat it. […] Susan had an excellent recovery after surgery, said Dr. Oyasiji. She continues to do very well and enjoy life to the fullest. I am so happy that our team was able to help her on her journey to beat cancer.
#47 Surgical and Functional Considerations of Dermatofibrosarcoma Protuberans Involving Facial Nerve Danger Zones | JCAD – The Journal of Clinical and Aesthetic Dermatology
https://jcadonline.com/dermatofibrosarcoma-danger-zones-december-2019/
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive tumor, uncommonly occurring on the head and neck where these deeply infiltrating tumors might violate underlying neurovascular structures. Treatment is typically surgical, whether by Mohs micrographic surgery (MMS) or wide local excision (WLE). […] The proper assessment and reporting of postoperative functional recovery should be undertaken following facial DFSP resection and consideration should be given to a multidisciplinary treatment approach. […] A multidisciplinary approach between dermatologic surgeons and otolaryngology-head and neck surgeons, as well as intraoperative Mohs micrographic surgery, could be beneficial in treating these patients. Further reporting, ideally with standardized metrics, of facial nerve injury and neurologic outcomes is needed to better counsel potential future surgical candidates.
#48 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible. […] Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] To enhance patient-centered care, outcomes, patient safety, and team performance related to DFSP, physicians, advanced practice practitioners, nurses, pharmacists, and other healthcare professionals must collaborate effectively using a multidisciplinary approach.
#49 CEConnection for Nursing : Skin Cancer Back to the Basics: Dermatofibrosarcoma Protuberans
https://nursing.ceconnection.com/public/modules/17677;jsessionid=86B5CFFF0601B89BDED44660CF10F086
After completing this continuing education activity you will be able to: […] Choose the appropriate treatment options for patients who have DFSP. […] Seventy-five percent of participants will demonstrate competency in clinical reasoning regarding dermatofibrosarcoma protuberans (DFSP) by achieving a minimum score of 70% on the outcomes based posttest.
#50 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] Healthcare professionals caring for patients with DFSP must be proficient in recognizing the characteristics of DFSP and accurately interpreting diagnostic tests such as biopsies and imaging studies. […] Developing a comprehensive care plan tailored to each patient’s unique needs is essential. […] Patients require vigilant monitoring for local recurrence posttreatment.
#51 Dermatofibrosarcoma Protuberans – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK513305/
Mohs micrographic surgery (MMS) involves the progressive horizontal slicing of tissue during resection, coupled with immediate microscopic evaluation via frozen section analysis. […] Some studies propose that MMS may result in lower local recurrence rates than WLE for DFSP. […] Radiation therapy is rarely used alone in the treatment of DFSP. […] Current NCCN guidelines recommend the use of adjuvant radiation in the following settings: Positive margins after surgical resection, Negative margins, with the closest margin being less than 1 cm in patients who did not undergo MMS, For recurrent or metastatic disease when surgical excision is not feasible. […] Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] To enhance patient-centered care, outcomes, patient safety, and team performance related to DFSP, physicians, advanced practice practitioners, nurses, pharmacists, and other healthcare professionals must collaborate effectively using a multidisciplinary approach.
#52 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] Healthcare professionals caring for patients with DFSP must be proficient in recognizing the characteristics of DFSP and accurately interpreting diagnostic tests such as biopsies and imaging studies. […] Developing a comprehensive care plan tailored to each patient’s unique needs is essential. […] Patients require vigilant monitoring for local recurrence posttreatment.
#53 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma primarily found on the trunk and proximal extremities that typically appears as a slowly progressing, firm, violet-red, or blue plaque. […] Surgical excision with clear margins is the preferred treatment, utilizing techniques like Mohs micrographic surgery or wide local excision. […] Patients require vigilant monitoring for local recurrence following curative treatment. […] The initial treatment for localized DFSP is surgical resection with negative margins. […] The risk of inadequate initial resection is high due to the delay in diagnosis and the tumor’s ability to invade surrounding tissues. […] Nearly 50% of patients will experience local recurrence with simple excision. […] For these reasons, pathological negative margins are necessary.
#54
https://scholars.duke.edu/individual/pub1595532
Twenty-two percent of patients underwent at least one re-excision. […] R0 resection was achieved at a second procedure in 80.2% and a third procedure in 86.2%. […] Ultimately, R0 resection was feasible in 89.5% of all patients. […] In total, 6.6% (N = 23) recurred (17 local, six distant). […] With a median follow-up of 47.0 months, disease-specific survival rate was 98.8%. […] In multivariable analysis, R0 margins at index resection were associated with wider circumferential margins and non-FST histology. […] In this international, multicenter collaborative, DFSP practice patterns were heterogeneous but achieved favorable recurrence rates and survival. […] Multiple excisions to clear margins remain commonplace and can inform future efforts to optimize margin selection.
#55
https://scholars.duke.edu/individual/pub1595532
Current patterns of care and outcomes for dermatofibrosarcoma protuberans: An international multi-institutional collaborative. […] Dermatofibrosarcoma protuberans (DFSP) is a cutaneous sarcoma with an infiltrative growth pattern that makes it challenging to clear margins. […] High quality data regarding DFSP natural history, management, and outcomes are limited. […] Data were retrospectively collected for adult DFSP patients who underwent resection at 10 institutions in eight countries. […] The majority (76.8%) were symptomatic at presentation. […] Preoperative imaging was used in 55.9% of cases. […] Diagnosis was established with excisional biopsy in 50.9% versus incisional biopsy in 25.0% of cases. […] Despite planned margins of 1.0 cm in 67.4% of cases, only 69.0% of patients achieved R0 resection.
#56
https://scholars.duke.edu/individual/pub1595532
Twenty-two percent of patients underwent at least one re-excision. […] R0 resection was achieved at a second procedure in 80.2% and a third procedure in 86.2%. […] Ultimately, R0 resection was feasible in 89.5% of all patients. […] In total, 6.6% (N = 23) recurred (17 local, six distant). […] With a median follow-up of 47.0 months, disease-specific survival rate was 98.8%. […] In multivariable analysis, R0 margins at index resection were associated with wider circumferential margins and non-FST histology. […] In this international, multicenter collaborative, DFSP practice patterns were heterogeneous but achieved favorable recurrence rates and survival. […] Multiple excisions to clear margins remain commonplace and can inform future efforts to optimize margin selection.
#57 Dermatofibrosarcoma Protuberans Treatment & Management: Approach Considerations, Medical Care, Surgical Care
https://emedicine.medscape.com/article/1100203-treatment
Because of its infiltrating growth pattern, DFSP commonly extends far beyond the clinical margins; this accounts in part for the high recurrence rate after standard surgical excision. Hence, a wide excision of 2-3 cm or more of the margins beyond clinically identifiable tumor border, down to and including the fascia, is recommended for the treatment of DFSP. […] Despite wide local excisions, an average recurrence rate of 15.7% is still observed among 1201 body cases and 51.8% is observed among 193 head and neck cases, as reported in the literature since 1951. A superior cure rate (an overall average recurrence rate of 1.3% among 463 cases reported) and tissue conservation are seen when Mohs micrographic surgery is used; thus, Mohs micrographic surgery is now considered the treatment of choice, particularly when a lesion is located in the head and neck region.
#58 Surgical and Functional Considerations of Dermatofibrosarcoma Protuberans Involving Facial Nerve Danger Zones | JCAD – The Journal of Clinical and Aesthetic Dermatology
https://jcadonline.com/dermatofibrosarcoma-danger-zones-december-2019/
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive tumor, uncommonly occurring on the head and neck where these deeply infiltrating tumors might violate underlying neurovascular structures. Treatment is typically surgical, whether by Mohs micrographic surgery (MMS) or wide local excision (WLE). […] The proper assessment and reporting of postoperative functional recovery should be undertaken following facial DFSP resection and consideration should be given to a multidisciplinary treatment approach. […] A multidisciplinary approach between dermatologic surgeons and otolaryngology-head and neck surgeons, as well as intraoperative Mohs micrographic surgery, could be beneficial in treating these patients. Further reporting, ideally with standardized metrics, of facial nerve injury and neurologic outcomes is needed to better counsel potential future surgical candidates.
#59 Dermatofibrosarcoma protuberans of the breast: A case study
https://www.spandidos-publications.com/10.3892/mco.2021.2212
Adjuvant external irradiation is used in cases with adverse prognostic factors such as high mitotic index and positive margins. […] Diagnosis of DFSP in breast is challenging because it is rare and imitates a wide range of benign and malignant breast lesions and requires an increased readiness for differentiating and managing it properly. […] Though a few treatments have been suggested, wide local excision or Mohs micrographic surgery remain the standard of care. […] To minimize recurrences, a personalized follow-up plan should be applied due to the lack of an existing evidence-based guideline.
#60 Surgical and Functional Considerations of Dermatofibrosarcoma Protuberans Involving Facial Nerve Danger Zones | JCAD – The Journal of Clinical and Aesthetic Dermatology
https://jcadonline.com/dermatofibrosarcoma-danger-zones-december-2019/
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive tumor, uncommonly occurring on the head and neck where these deeply infiltrating tumors might violate underlying neurovascular structures. Treatment is typically surgical, whether by Mohs micrographic surgery (MMS) or wide local excision (WLE). […] The proper assessment and reporting of postoperative functional recovery should be undertaken following facial DFSP resection and consideration should be given to a multidisciplinary treatment approach. […] A multidisciplinary approach between dermatologic surgeons and otolaryngology-head and neck surgeons, as well as intraoperative Mohs micrographic surgery, could be beneficial in treating these patients. Further reporting, ideally with standardized metrics, of facial nerve injury and neurologic outcomes is needed to better counsel potential future surgical candidates.
#61
https://journals.lww.com/md-journal/fulltext/2023/11170/effective_resection_of_dermatofibrosarcoma.87.aspx
The average follow-up was 41.2 months after surgery (range, 4123 months), and no instances of recurrence were noted. […] Considering the invasiveness of DFSP, the degree of invasion of deep tissues must also be assessed to minimize the risk of local recurrence. […] Our newly developed Saturns rings technique takes into account the width and depth of resection. […] Therefore, we devised the Saturns rings technique, combining the advantages of wide excision and MMS, and applied it to 29 patients with DFSP of the trunk or limbs. […] This surgical technique reduces the physical and psychological burden on both the patient and the surgeon. […] We used a novel marginal resection method in 29 patients diagnosed with DFSP in the extremities and trunk and achieved safe results with no recurrence over a follow-up period of at least 9 months. […] Furthermore, the results were advantageous for reconstruction after resection, and the outcomes were cosmetically satisfactory.
#62 Dr. Alshaygy on Resection Margin for Dermatofibrosarcoma Protuberans
https://www.onclive.com/view/dr-alshaygy-on-resection-margin-for-dermatofibrosarcoma-protuberans
Ibrahim S. Alshaygy, MD, MSC, discusses research suggesting a smaller surgical resection margin for dermatofibrosarcoma protuberans. […] The current standard of care is to remove the tumor with a wide margin resection, but recent research shows that a negative margin can be achieved with smaller resections. […] As long as a negative margin is achieved, enough tissue has been removed, which can lead to fewer adverse events, better cosmesis, and better functional outcomes for the patient, says Alshaygy. […] Additionally, the new follow-up protocol can impact the clinic follow-up and patient follow-up regimen, which saves physicians and patients time in the clinic, concludes Alshaygy.
#63 Dermatofibrosarcoma Protuberans | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20385
Patients should participate in regular self-examination, and the primary site should be examined every 6 months for 3 to 5 years. […] Through comprehensive patient education and proactive deterrence strategies, clinicians can empower individuals to take an active role in their skin health and facilitate early detection and treatment of DFSP. […] Healthcare professionals caring for patients with DFSP must be proficient in recognizing the characteristics of DFSP and accurately interpreting diagnostic tests such as biopsies and imaging studies. […] Developing a comprehensive care plan tailored to each patient’s unique needs is essential. […] Patients require vigilant monitoring for local recurrence posttreatment.
#64 Dermatofibrosarcoma Protuberans (DFSP) | Dermatologist | La Porte & Valparaiso, IN |Applegarth Dermatology PC
https://www.applegarthdermatology.com/articles/aad_education_library/920158-dermatofibrosarcoma-protuberans-dfsp/
It is important to discuss the potential side effects of DFSP treatment with your doctor before starting any treatment. […] Prognosis refers to a prediction of the likely outcome of a disease. For someone with DFSP the prognosis depends on many factors, including the stage of the tumor, the type of treatment received, and the person’s overall health. However, most people with DFSP can expect to have a good outcome. […] DFSP is a type of skin cancer that can be very aggressive and difficult to treat. However, with early diagnosis and treatment, most people with DFSP can expect to have a good outcome. Remember, you are not alone! Don’t hesitate to reach out to your doctor.