Photoletter to the editor: Atrophic dermatofibrosarcoma protuberans with minimal clinical manifestation

Abstract

Dermatofibrosarcoma protuberans is an uncommon soft tissue neoplasm. In the vast majority of cases it presents as a nodule or a firm tumor that can reach massive dimensions producing the protuberant nodules for which it is named. We report a case of a 34-year-old woman presented at our department with an 8-year history of a small and discretely erythematous supraclavicular atrophic plaque. Skin biopsy lead to the diagnosis of dermatofibrosarcoma protuberans and a wide local excision of the tumor was performed in collaboration with the Plastic Surgery department. In this clinical case we describe an uncommon variant of the disease with minimal clinical manifestation that can cause serious diagnostic difficulties. The small and discrete atrophic plaque of our patient could have been easily ignored with serious clinical and prognostic implications for the patient.

Keywords: carcinoma; dermatofibrosarcoma protuberans; sarcoma.

Figure 1

Small erythematous left supraclavicular atrophic plaque.

Figure 2

A photomicrograph showing (A) (H&E x100), tumor occupying all dermis and invading the hypodermis (B) (H&E x400), spindle cell tumor (C) (S100 x100), S100 is negative (D) (CD34 x100) tumor cells show positivity for CD34.