Dermatofibrosarcoma protuberans of the forehead: a case report

Abstract

A 56-year-old male was admitted to the hospital for a mass on the left forehead for more than one year. Twenty years prior to the presentation, the patient developed a broad bean-sized nodule on the left forehead, thereafter, an in situ resection was performed. One year prior to the presentation, the lesion recurred and gradually enlarged with no evident symptom. Physical examination showed a pink, painless and indurated mass measuring 3 cm × 2 cm × 1 cm on the left forehead. The lesion appeared as a hemispheroid-shaped elevation, had a smooth and tense surface, and was adherent to skin but not to deep fascia. There was an obvious depression around the mass. Histopathological examination revealed an evident proliferation of spindle cells with a braid-like distribution in the mid- and lower dermis. Mild atypia was observed in these cells.Immunohistochemistry revealed that the tumor cells were positive for CD34 and vimentin, but negative for CK, S-100 and epithelial membrane antigen. A diagnosis of dermatofibrosarcoma protuberans was made. The lesion was resected followed by a free full thickness skin graft. After operation, the flap survived well, and a satisfactory outcome was achieved. Key words: Dermatofibrosarcoma; Skin; Skin transplantation