Surgical treatment for dermatofibrosarcoma protuberans: the Dartmouth experience and literature review

Ann Plast Surg. 2008 Mar;60(3):288-93. doi: 10.1097/SAP.0b013e31805342eb.


Introduction: Dermatofibrosarcoma protuberans (DFSP) is an invasive soft tissue tumor with asymmetric pattern of growth and propensity for recurrences, thus warranting systematic treatment planning at onset. We conducted a retrospective analysis of 25 patients with DFSP that received either wide excision, modified wide excision (with horizontal processing), Mohs micrographic surgery (MMS), or combination surgery. Follow-up ranged from 15-133 months, with a median of 68 months.

Results/conclusions: Fourteen patients were treated with wide excision, 4 with modified wide excision, 6 with MMS followed by modified wide excision, and 1 with MMS. No recurrences were reported. Patients with lesions arising from "cosmetically sensitive" areas (head and neck) most often underwent MMS or modified wide excision. Our study supports that all 4 surgical treatment methods were successful in achieving recurrence-free survival, but emphasis on presurgical planning and patient selection for each surgical approach is key to allow for the least complicated repair while maximizing tissue preservation.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Dermatofibrosarcoma / pathology*
  • Dermatofibrosarcoma / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mohs Surgery / methods*
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery*