Abstract
Dermatofibrosarcoma protuberans (DFSP) is an uncommon, painless, slow-growth, superficial soft tissue malignant sarcoma corresponding to less than 0.1% of all malignancies. The primary treatment for DFSP is surgical excision, which is wide local excision (WLE) with tumor-free margins, Mohs micrographic surgery (MMS), and partial or total amputation. The goal of surgical excision is to achieve negative resection margins, thus reducing the local recurrence rate. These three cases reported large dermatofibrosarcoma, which began as a small nodule and progressed within approximately a year and were treated subsequently with wide excisions surgery. The unique and challenging part for most surgeons is removing the mass with a concentric excision due to its specific growth pattern. To achieve negative resection margins, the width of the tumor-free margins and infiltrating depth are two essential factors to be considered for complete excision for both WLE and MMS surgical techniques. Adjuvant therapy, including radiotherapy and targeted therapy, is reserved for unresectable, advanced stage, or recurrent tumors.
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