Abstract
Background: Surgical scars are not a well-known risk factor for the development of dermatofibrosarcoma protuberans (DFSP). However, DFSP can arise within a surgical scar.Objective: This study determined the number of DFSP found within scars from prior surgical procedures at a tertiary academic cancer center.Methods: A retrospective data analysis was performed of all patients with biopsy-proven DFSP from January 2000 to April 2018 at MD Anderson Cancer Center (MDACC), a tertiary referral cancer center. Chart review was performed, and data were recorded for gender, race, and age of patients. We also recorded the site, location, and size of the DFSP and whether the patients had a history of prior surgery at the DFSP site. All patients had a pathologic diagnosis of DFSP at MDACC. Patients were selected from the pathology database at MDACC using the keywords “DFSP” or “dermatofibrosarcoma protuberans”. A total of 458 patients were identified; however, 94 patients were excluded from the study because they were only referred to MDACC with a confirmed diagnosis of DFSP and were not seen as patients by a MDACC physician.Results: Of the remaining 364 patients, 37 patients (10.1%) had either a history of a benign neoplasm or an inflammatory disease that had been evaluated or treated by either punch biopsy, shave biopsy, or minor excision at the site of DFSP (8.5%, 31 patients) or a DFSP arising within a major surgical procedural scar (1.6%, six patients). The surgical sites identified were the abdomen (four patients) and the groin (two patients). Three of the patients with a major surgical scar DFSP had prior laparoscopic surgery at the site.Conclusions: DFSPs occur at surgical scars. The development of surgical scar DFSP in 10% of our patients prompts us to postulate that the neoplasm may be associated with the malignant transformation of these scars.
Highlights
Dermatofibrosarcoma protuberans (DFSP) is a rare subcutaneous and/or dermal tumor that is locally aggressive with frequent recurrence
Of the remaining 364 patients, 37 patients (10.1%) had either a history of a benign neoplasm or an inflammatory disease that had been evaluated or treated by either punch biopsy, shave biopsy, or minor excision at the site of dermatofibrosarcoma protuberans (DFSP) (8.5%, 31 patients) or a DFSP arising within a major surgical procedural scar (1.6%, six patients)
The development of surgical scar DFSP in 10% of our patients prompts us to postulate that the neoplasm may be associated with the malignant transformation of these scars
Summary
Dermatofibrosarcoma protuberans (DFSP) is a rare subcutaneous and/or dermal tumor that is locally aggressive with frequent recurrence. There is less local recurrence when DFSP is treated with Mohs micrographic surgery [1]. It has an annual incidence in the United States of approximately 4.5 per million [2]. The tumor is typically diagnosed in young to mid-aged patients. The incidence in blacks is almost two times higher than in whites. A poorer survival is associated with increased age, male gender, tumors located on the limbs and head, and black race [3]. Surgical scars are not a well-known risk factor for the development of dermatofibrosarcoma protuberans (DFSP). DFSP can arise within a surgical scar
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call