隆起性皮膚線維肉腫の切除縁—治療方針—

Resection Margins for Dermatofibrosarcoma protuberans (DFSP): The Treatment Strategy

　Dermatofibrosarcoma protuberans (DFSP) is a rare, intermediate (locally aggressive) soft-tissue tumor with locally destructive growth and a high local recurrence rate, although metastases are rare. The tumor cells tend to grow into the subcutaneous tissue, making it difficult to accurately identify the margins of the lesion on clinical examination. In addition, DFSP tends to spread in a unique infiltrative growth pattern, interlacing into subcutaneous tissue, fascia, and occasionally muscle or bone. This easily leads to an incomplete resection and/or local recurrence, which are major problems in the surgical treatment of DFSP. The cases of three patients with DFSP are presented herein, together with their unique MRI findings.

　DFSP varies greatly from case to case in terms of the lesion depth, the pattern of invasion, and border distinctness. A standard application of the guidelines concerning the treatment of DFSP may thus result in an incomplete resection or, conversely, an excessive resection. Preoperative imaging studies are therefore very important for appropriate surgical planning.