Fine needle aspiration cytology of dermatofibrosarcoma protuberans: A rare case report

Abstract

Introduction: Dermatofibrosarcoma protuberans (DFSP) is an uncommon cutaneous spindle cell tumor with incidence 0.8 to 5 cases/million population/year.1 found almost exclusively in the dermis, from which they often invade the subcutaneous tissue. It is a slow-growing, locally aggressive tumor of intermediate malignancy. It poses a diagnostic challenge when encountered on fine needle aspiration cytology (FNAC) owing to its rarity and characteristics that are indistinguishable from other spindle cell lesions. It has high tendency for local recurrence but low rate of distant metastasis.Case report: 26 years old female presented in department of surgery as a mass in the epigastric region which was painless and progressive since 6 months. Ultrasonography was done which was suggestive of neoplastic etiology with possibility of dermatofibrosarcoma protuberans. Patient was advised FNAC.Methods: FNAC was done without local anaesthesia and smears were made. Smears were fixed with methanol and stained by PAP’s stain, H&E stain and unfixed slides were stained by MGG stain. Detailed cytomorphological features were studied.Result: Smears showed spindle cell tumor suggestive of DFSP on cytology and it was confirmed by histopathology.Conclusion: Distinguishing dermatofibrosarcoma protuberans from other spindle cell tumors and fibrohistiocytic lesions may pose significant challenges to the pathologist. However, in the appropriate clinical setting and applying strict diagnostic criteria, fine needle aspiration cytology is a reliable tool in establishing the diagnosis of this neoplasm.