Clinical and pathological changes in a long-term follow-up case of dermatofibrosarcoma protuberans
Clinical and pathological changes in a long-term follow-up case of dermatofibrosarcoma protuberans
复制标题
隆突性皮肤纤维肉瘤长期随访临床病理变化一例
DOI：
10.1111/j.1346-8138.2010.00938.x
复制
发表时间：
2011
期刊：
影响因子：
3.1
通讯作者：
Fukumi Furukawa
中科院分区：
文献类型：
--
作者：
Yuki Yamamoto;Seiko Toyozawa;Koji Uede;Yoshinao Oda;Yasushi Nakamura;Fukumi Furukawa
摘要隆突性皮肤纤维肉瘤是一种中等恶性程度的软组织肿瘤，其特征为缓慢的浸润性生长，手术切除后有明显的局部复发倾向。1我们报告了1例首次手术切除后20年内多次复发和手术的DFSP患者的长期临床病史和病理变化，如复发性和CD 34表达。一名28岁的男子被视为在我们的医院由于皮下肿瘤的区域，他的左眉。他告诉我们他在8年前接受了相同病变的切除治疗。体格检查时，发现他无症状，肿瘤是一个直径1.5厘米的圆形硬结节。肿瘤广泛切除，并通过皮肤移植重建。该肿瘤具有DFSP的组织学体征，因为细长的梭形细胞在真皮中排列成区域斯托状图案。组织学切缘未见肿瘤细胞，但1年后肿瘤在皮片下复发，于本院施行第二次全切除术。尽管全切除，复发性病变出现在右前额外侧的皮肤移植11年后。第三个肿瘤切除术进行重建皮肤移植。组织学边缘肿瘤细胞呈阴性。从我们诊所第一次手术切除16年后，肿瘤再次出现在左脸颊上。根据患者的意愿，通过简单切除（第四次）治疗这些病变。在他第一次就诊（47岁）的19年后，左脸颊上的肿瘤继续缓慢生长，
Dear Editor, Dermatofibrosarcoma protuberans (DFSP) is a soft tissue neoplasm of intermediate malignancy characterized by a pattern of slow, infiltrative growth and a marked tendency to recur locally after surgical excision. 1 We experienced a case of DFSP who had several recurrences and surgeries in the 20 years after the first surgical excision, and we present his longterm clinical history and pathological changes such as its atypicality and CD34 expression. A 28-year-old man was seen at our hospital due to a subcutaneous tumor in the region of his left eyebrow. He told us that he had received excision therapy on the same lesion 8 years before. On physical examination, he was found to be asymptomatic, and the tumor was a round and hard nodule 1.5 cm in diameter. The wide resection of tumor was performed, and reconstructed by a skin graft. The tumor had histological signs of DFSP in that slender spindle cells were arranged in a district storiform pattern in the dermis. Histological margins were negative for tumor cells.However, the tumor was recurrent under the skin graft after 1 year and the second total resection in our hospital was performed. In spite of total resection, recurrent lesions arose on the right forehead on the outer side of the skin graft after 11 years. A third tumor resection was performed with reconstruction by skin graft. Histological margins were negative for tumor cells. After 16 years from the first surgical excision in our clinic, the tumor appeared again on the left cheek. These lesions were treated by a simple resection (the fourth) following the patient’s wish. Nineteen years after his first visit (47 years of age), the tumor on the left cheek had continued to grow slowly, and a