Dermatofibrosarcoma of the scalp

Abstract

A 25-year-old woman presented with a 4 months history of progressive pain and tumefaction in the right parietal region. Deformity of the scalp was evident, and a biopsy was taken, reporting a high- grade dermatofibrosarcoma. She underwent surgical management, achieving a gross total resection. Dermatofibrosarcoma protuberans is a rare tumor arising from the dermis. It tends to have an indolent course and local recurrence after excision.

Keywords: Dermatofibrosarcoma; Protuberans; Scalp.

Figure 1:

Magnetic resonance imaging: (a) coronal T2 weighted sequence and (b) axial T1 weighted sequence, which show a solid, homogeneous, and exophytic mass in the right parietal region. Bone erosion is present; however, brain parenchyma invasion is not evident.

Figure 2:

Macroscopic findings. (a and b): a greyish, solid, soft, and homogeneous tumor with an ovoid irregular shape weighing 500 g and measuring 12.5 cm × 10.5 cm × 8 cm was completely resected. In the uppermost portion of the lesion, an ulcerated area of 7 cm × 5.5 cm was observed.

Figure 3:

Histopathologic findings. (a) Dermatofibrosarcoma protuberans expands and infiltrates the dermis, while epidermis shows important thinning. H and E stain ×10. (b) Spindle cells with scant eosinophilic cytoplasm usually are centered on a small vessel. H and E stain ×10. (c) Classic storiform pattern: cells radiating in spokes at right angles around a central point that often contains a vessel. H and E stain ×10 (d) H and E ×100 magnification in which the storiform or cartwheel pattern can be better appreciated.