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Gunasekaran V, Peters NJ, Samujh R. Congenital giant Bednar tumor in a child: surgical challenges in a young infant: a case report. ANNALS OF PEDIATRIC SURGERY 2020. [DOI: 10.1186/s43159-020-00048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Bednar tumor is a pigmented variant of the uncommon dermatofibrosarcoma protuberans (DFSP). It is a disease of the middle aged and elderly and has been rarely described in the pediatric population.
Case presentation
We report a rare case of a giant Bednar tumor present since birth, in a 2-year-old male child. It was present over the lower back and managed by surgical excision.
Conclusions
Bednar tumor is a rarity in children and is managed with aggressive wide local excision with margin of at least 1 cm. A close clinical follow-up is mandatory.
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Current Update on the Molecular Biology of Cutaneous Sarcoma: Dermatofibrosarcoma Protuberans. Curr Treat Options Oncol 2019; 20:29. [PMID: 30874910 DOI: 10.1007/s11864-019-0628-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OPINION STATEMENT Cutaneous sarcoma is a group of malignant mesenchymal tumors primarily involving the dermis, and it is characterized by extreme clinicopathological heterogeneity. Although its occurrence rate is rare, dermatofibrosarcoma protuberans (DFSP) is one of the most common types of dermal sarcoma. DFSP grows slowly and tends to relapse locally after inadequate resection. There are various histological variants of DFSP tumors and it often mimics benign lesions such as dermatofibroma and scar, which make accurate diagnosis difficult and delayed, and some cases progress to the stage where the tumor is unresectable. Recent advancements in cancer genetics and molecular biology methods have elucidated the COL1A1-PDGFB fusion gene, some novel fusion gene variants and pathways related to DFSP pathogenesis that have resulted in the evolution of cutaneous sarcoma diagnosis and treatment. For example, some clinical studies have confirmed the efficacy of imatinib methylate, an αPDGFR-targeted therapy for unresectable or metastatic DFSP. The present review summarizes recent updates in DFSP research, diagnostics, and treatment.
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Yadav S, Verma N, Khurana N, Neogi S. Recurrent Dermatofibrosarcoma Protuberans with Pigmentation and Myoid Differentiation. Sultan Qaboos Univ Med J 2018; 18:e228-e230. [PMID: 30210857 DOI: 10.18295/squmj.2018.18.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/25/2017] [Accepted: 02/01/2018] [Indexed: 11/16/2022] Open
Abstract
Dermatofibrosarcomas protuberans (DFSP) are rare low-grade tumours with various subtypes and usually occur among middle-aged adults. However, myoid differentiation is very rare. We report a 44-year-old woman who presented to the Lok Nayak Jai Prakash Hospital, New Delhi, India, in 2017 with a recurrent pigmented DFSP presenting as an arm swelling. Upon histological and immunohistochemical analysis, myoid differentiation was confirmed. A literature review of the clinical and histopathological features of this rare entity is presented.
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Affiliation(s)
- Surekha Yadav
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nidhi Verma
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Sushant Neogi
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
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Abstract
Bednar tumor is an uncommon variant of dermatofibrosarcoma protuberans. Also known as pigmented dermatofibrosarcoma protuberans, this tumor is of intermediate grade. It is seen in adults and has a predisposition to affect the shoulder region. We report a rare case of Bednar tumor in a 40-year-old female patient. The diagnosis of Bednar tumor must be considered while reporting pigmented subcutaneous spindle cell lesions.
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Affiliation(s)
- Gayathri P Amonkar
- Department of Pathology, T.N. Medical College and B.Y.L. Nair Hospital, Mumbai, India
| | - Asha Rupani
- Department of Pathology, T.N. Medical College and B.Y.L. Nair Hospital, Mumbai, India
| | - Ajay Shah
- Department of Pathology, T.N. Medical College and B.Y.L. Nair Hospital, Mumbai, India
| | - Ramesh Deshpande
- Department of Pathology, T.N. Medical College and B.Y.L. Nair Hospital, Mumbai, India
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Añón-Requena MJ, Pico-Valimaña M, Muñoz-Arias G. Bednar Tumor (Pigmented Dermatofibrosarcoma Protuberans). ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:618-20. [PMID: 26945477 DOI: 10.1016/j.ad.2015.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/22/2015] [Accepted: 10/31/2015] [Indexed: 11/18/2022] Open
Affiliation(s)
- M J Añón-Requena
- Unidad de Gestión Clínica, Intercentros de Anatomía Patológica Bahía de Cádiz, Hospital Universitario Puerto Real, Cádiz, España.
| | - M Pico-Valimaña
- Sección de Dermatología, Unidad de Gestión Clínica Bloque Quirúrgico, Hospital Universitario Puerto Real, Cádiz, España
| | - G Muñoz-Arias
- Unidad de Gestión Clínica, Intercentros de Anatomía Patológica Bahía de Cádiz, Hospital Universitario Puerto Real, Cádiz, España
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Tatai T, Gomi D, Fukushima T, Kobayashi T, Sekiguchi N, Sakamoto A, Sasaki S, Koizumi T, Sano K. Effectiveness of Imatinib Mesylate Treatment in a Patient with Dermatofibrosarcoma Protuberans with Pulmonary and Pancreatic Metastases. Intern Med 2016; 55:2507-11. [PMID: 27580559 DOI: 10.2169/internalmedicine.55.6836] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein encountered a case of abdominal wall dermatofibrosarcoma protuberans (DFSP) that developed pulmonary and pancreatic metastases 5 years after complete resection. Because specific rearrangements of the platelet-derived growth factor beta (PDGFB) locus by a novel fluorescence in situ hybridization method was detected, the patient was treated with imatinib mesylate at 400 mg/day. A partial response was achieved by imatinib without any specific toxicity. Although metastatic DFSP is an extremely rare disease, an evaluation of PDGFB fusion is essential and imatinib mesylate should be considered as an optimal therapeutic choice in patients with metastatic or locally advanced DFSP.
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Affiliation(s)
- Toshiharu Tatai
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
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Dhir M, Crockett DG, Stevens TM, Silberstein PT, Hunter WJ, Foster JM. Neoadjuvant treatment of Dermatofibrosarcoma Protuberans of pancreas with Imatinib: case report and systematic review of literature. Clin Sarcoma Res 2014; 4:8. [PMID: 25276339 PMCID: PMC4179866 DOI: 10.1186/2045-3329-4-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/07/2014] [Indexed: 11/17/2022] Open
Abstract
Dermatofibrosarcoma Protuberans (DFSP) is a rare skin tumor, characterized by frequent local recurrence but is seldom metastatic. It is histologically characterized by storiform arrangement of spindle cells. Cytogenetically, most tumors are characterized by translocation 17:22 leading to overexpression of tyrosine kinase PDGFB which can be targeted with tyrosine kinase inhibitor, Imatinib. We describe the first case of unresectable pancreatic metastases from DFSP treated with neoadjuvant Imatinib and subsequently R0 metastectomy. Additionally, a comprehensive systematic review of DFSP pancreatic metastases and the current published data on the use of Imatinib in DFSP is summarized.
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Affiliation(s)
- Mashaal Dhir
- Department of Surgery, Surgical Oncology, 986345 University of Nebraska Medical Center, Omaha, NE 68198-6345, USA
| | - David G Crockett
- Department of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Todd M Stevens
- Department of Pathology, University of Missouri, Kansas City, MO, USA
| | - Peter T Silberstein
- Department of Hematology and Oncology, Creighton University Medical Center, Omaha, NE, USA
| | - William J Hunter
- Department of Anatomic Pathology, Creighton University Medical Center, Omaha, NE, USA
| | - Jason M Foster
- Department of Surgery, Surgical Oncology, 986345 University of Nebraska Medical Center, Omaha, NE 68198-6345, USA
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Ishida M, Okabe H. Fibrosarcomatous pigmented dermatofibrosarcoma protuberans: A case report with review of the literature. Oncol Lett 2013; 4:390-392. [PMID: 23741240 DOI: 10.3892/ol.2012.765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 06/12/2012] [Indexed: 11/05/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a relatively rare low-grade sarcoma that occasionally exhibits melanin-containing spindle cells within the tumor. Fibrosarcomatous DFSP (FS-DFSP) is a variant that is characterized by areas which are histopathologically indistinguishable from fibrosarcoma. In the present study, we describe a case of fibrosarcomatous pigmented DFSP and review the clinicopathological features of this extremely rare lesion. A 51-year-old male presented with a slow-growing nodular cutaneous mass in his left upper arm. Histopathologically, the resected tumor was comprised of pigmented DFSP in approximately 20% of the tumor, with the remaining area further covered by a fibrosarcomatous component. A review of the clinicopathological features of the five previously reported cases as well as the present case indicated that this lesion mainly affects middle-aged males and occurs mostly in the extremities. Melanin-containing spindle cells are present only in the conventional DFSP component. The prognosis appears to be poor; in the six cases reviewed, four demonstrated multiple metastases and three succumbed to the disease. Our analyses revealed that the presence of a fibrosarcomatous component in pigmented DFSP is associated with aggressive behavior; therefore, careful assessment for the presence of a fibrosarcomatous component is necessary in the diagnosis of this disease.
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Affiliation(s)
- Mitsuaki Ishida
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
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Llombart B, Serra-Guillén C, Monteagudo C, López Guerrero JA, Sanmartín O. Dermatofibrosarcoma protuberans: a comprehensive review and update on diagnosis and management. Semin Diagn Pathol 2013; 30:13-28. [DOI: 10.1053/j.semdp.2012.01.002] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Voth H, Landsberg J, Hinz T, Wenzel J, Bieber T, Reinhard G, Höller T, Wendtner CM, Schmid-Wendtner MH. Management of dermatofibrosarcoma protuberans with fibrosarcomatous transformation: an evidence-based review of the literature. J Eur Acad Dermatol Venereol 2011; 25:1385-91. [DOI: 10.1111/j.1468-3083.2011.04141.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Garg MK, Yadav MK, Gupta S, Kumar N, Khandelwal N. Dermatofibrosarcoma protuberans with contiguous infiltration of the underlying bone. Cancer Imaging 2009; 9:63-6. [PMID: 19933019 PMCID: PMC2792083 DOI: 10.1102/1470-7330.2009.0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade, cutaneous neoplasm with pronounced tendency for local recurrence. A case of DFSP that showed direct infiltration into the underlying bone marrow is described. To the best of our knowledge, such direct bony involvement by dermatofibrosarcoma has not been reported in the English literature to date. The role of imaging is also discussed for planning adequate initial treatment, which will result in a lower recurrence rate and improved clinical outcome.
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Affiliation(s)
- Mandeep Kumar Garg
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh-160012, India.
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Wang J, Yang W. Pigmented dermatofibrosarcoma protuberans with prominent meningothelial-like whorls. J Cutan Pathol 2008; 35 Suppl 1:65-9. [DOI: 10.1111/j.1600-0560.2007.00963.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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