Diagnostic and Surgical Challenges in Recurrent Dermatofibrosarcoma Protuberans: A Case Report

Diagnostic and Surgical Challenges in Recurrent Dermatofibrosarcoma Protuberans: A Case Report

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Dermatofibrosarcoma Protuberans (DFSP) is a low-grade cutaneous soft-tissue sarcoma that originates in the dermis and infiltrates deeper structures.It comprises less than one percent of all soft-tissue sarcomas and is histologically defined by their slow growth, localised invasiveness and a tendency to recur when not adequately excised.However, unlike other cancers, distant metastasis is Gear Shift Extensions relatively uncommon; the invasive nature of DFSP infiltration causes diagnostic and therapeutic challenges.DFSP can involve any area of the body; however, it predominantly favours the trunk and extremities.

The mainstay of management is wide local excision, which should achieve negative margins, as inadequate margins have a propensity to recur.Recurrent cases require specific surgical management to balance oncological security with the management of their consequences.The presented case involves a 72-year-old man with recurrent DFSP, manifesting as a long-standing swelling of the left great toe that progressively increased over 10 years.Initially, conservative treatment was attempted, but the condition became symptomatic, leading to excision and a diagnosis of Chronic Granulomatous Changes (CGC) and liquefactive necrosis.

Although the swelling was initially excised, it recurred after eight L-Carnitine months and was treated by amputation due to its aggressive nature and the impossibility of definitive resection.Radical surgical re-intervention for wound dehiscence, which later reopened, was supplemented by Split-thickness Skin Grafting (SSG).In the management of recurrent soft-tissue tumours, early diagnosis and individualised treatment planning should be emphasised to maximise patient outcomes and minimise recurrence.