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Gonzalez Díaz C, Olmos Perez M, Guiot Isaac N, Herazo Aguirre I. Dermatofibrosarcoma Protuberans: A Series of 14 Patients in Whom High-Resolution Ultrasound Was the Key to Diagnosis. Actas Dermosifiliogr 2024; 115:312-315. [PMID: 37848133 DOI: 10.1016/j.ad.2023.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/24/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- C Gonzalez Díaz
- Radióloga, experta en ultrasonido Dermatológico, Bogotá, Colombia
| | - M Olmos Perez
- Dermatólogo, especialista de cirugía dermatológica, docente FUCS, Bogotá, Colombia
| | - N Guiot Isaac
- Residentes de último año dermatología FUCS, Bogotá, Colombia.
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Gonzalez Díaz C, Olmos Perez M, Guiot Isaac N, Herazo Aguirre I. [Translated article] Dermatofibrosarcoma Protuberans: A Series of 14 Patients in Whom High-Resolution Ultrasound Was the Key to Diagnosis. Actas Dermosifiliogr 2024; 115:T312-T315. [PMID: 38224735 DOI: 10.1016/j.ad.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/24/2023] [Indexed: 01/17/2024] Open
Affiliation(s)
- C Gonzalez Díaz
- Radióloga, experta en ultrasonido Dermatológico, Bogotá, Colombia
| | - M Olmos Perez
- Dermatólogo, especialista de cirugía dermatológica, docente FUCS, Bogotá, Colombia
| | - N Guiot Isaac
- Residente de último año dermatología FUCS, Bogotá, Colombia.
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Zhu H, Wu S. Integrating vascularity into the pattern classification of pilomatricomas on ultrasound provides a more competent approach for discriminative evaluation. Skin Res Technol 2024; 30:e13585. [PMID: 38279551 PMCID: PMC10818091 DOI: 10.1111/srt.13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Pilomatricoma has various manifestations on color Doppler ultrasound, and a differential diagnosis is challenging. The objective of this study was to investigate which characteristics of skin lesions on color Doppler ultrasound are effective in distinguishing pilomatricoma from epidermoid cyst and dermatofibrosarcoma protuberans. MATERIALS AND METHODS Records of patients with pilomatricomas (n = 63), epidermoid cysts (n = 76), and dermatofibrosarcoma protuberans (n = 19) who underwent color Doppler ultrasound evaluation and surgical excision were reviewed. The anatomical distribution and color Doppler ultrasound characteristics of these lesions were analyzed. The 63 pilomatricomas were categorized into five types based on their color Doppler ultrasound characteristics, and the roles of these five types in the differential diagnosis of the aforementioned diseases were studied. RESULTS Pilomatricomas, epidermoid cysts, and dermatofibrosarcoma protuberans exhibited some similar characteristics. Dominantly markedly hyperechoic or hyperechoic appearance, posterior acoustic shadowing, and the presence of vascularity were the major characteristics of pilomatricomas. The pilomatricomas could be categorized into five types, with type II having a diagnostic performance of sensitivity of 65.08%, specificity of 98.95%, area under the receiver operating characteristic curve (AUC) of 0.743, positive predictive value of 97.62%, and negative predictive value of 81.03% for the diagnosis of the aforementioned skin diseases. CONCLUSION A combination of dominantly markedly hyperechoic or hyperechoic appearance, posterior acoustic shadowing, and the presence of vascularity exhibits higher diagnostic performance for the differential diagnosis of pilomatricomas, epidermoid cysts, and dermatofibrosarcoma protuberans.
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Affiliation(s)
- Huiling Zhu
- Department of UltrasoundThe First Affiliated Hospital of Hainan Medical UniversityHaikouChina
| | - Size Wu
- Department of UltrasoundThe First Affiliated Hospital of Hainan Medical UniversityHaikouChina
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Gualdi G, La Rosa G, Di Buduo A, Paradisi A, Soglia S, Calzavara-Pinton P, Amerio P. Conventional surgery compared with formalin-fixed tissue Mohs surgery (slow Mohs) for DFSP: A comparative analysis of 83 cases. J Eur Acad Dermatol Venereol 2023; 37:e1393-e1395. [PMID: 37458274 DOI: 10.1111/jdv.19336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Giulio Gualdi
- Department of Medicine and Aging Science, Dermatologic Clinic, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giuseppe La Rosa
- Dermatologic Clinic, Spedali Civili, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Andrea Di Buduo
- Department Medical Sciences, and Public Health, Dermatology Clinic, University of Cagliari, Cagliari, Italy
| | - Andrea Paradisi
- Dermatology. Department of Medicine and translational surgery, Catholic University of Sacred Heart, Rome, Italy
- UOC of Dermatology, Department of medical and surgical sciences, A. Gemelli University Polyclinic Foundation - IRCCS, Rome, Italy
| | - Simone Soglia
- Dermatologic Clinic, Spedali Civili, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | | | - Paolo Amerio
- Department of Medicine and Aging Science, Dermatologic Clinic, University G D'Annunzio Chieti-Pescara, Chieti, Italy
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Kim GW, Bae YC, Hong JH, Kim HS, Yi CC. Effective resection of dermatofibrosarcoma protuberans using the novel Saturn's rings technique. Medicine (Baltimore) 2023; 102:e36031. [PMID: 37986363 PMCID: PMC10659602 DOI: 10.1097/md.0000000000036031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/16/2023] [Accepted: 10/18/2023] [Indexed: 11/22/2023] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade sarcoma with locally infiltrative characteristics. A wide excision is made with a 5 cm gross margin. However, recently, Mohs micrographic surgery has emerged as an alternative. In this study, we evaluate a novel method (Saturn's Rings technique) for removing tumors that combines the advantages of wide excision and Mohs micrographic surgery. Between September 2001 and March 2020, 29 patients with DFSP, excluding the head and neck, were treated using Saturn's rings technique. Frozen biopsies were performed at regular intervals under various conditions and depths. If the biopsy was positive, a negative margin was obtained through an additional session. The depth and breadth of excision, reconstruction method, and postoperative recurrence were analyzed. The breadth of excision was evaluated at 1 cm intervals. Only 1 session was required in 12 cases, 2 sessions were needed in 13 cases, and 3 or more sessions were performed in 4 cases. In 24 cases, the depth of excision was limited to above the superficial fascia, with a negative biopsy of the superficial fascia. Local flaps were the most common reconstruction method (n = 21, 72.4%). No cases of recurrence were observed at follow-up (average, 45.7 months). Saturn's rings technique for DFSP maximized the preservation of normal tissue with minimal resection, was advantageous for reconstruction, and yielded good results without recurrence.
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Affiliation(s)
- Geon Woo Kim
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Yong Chan Bae
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Jung Hyun Hong
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Hoon-Soo Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Republic of Korea
| | - Changryul Claud Yi
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Gimeno-Ribes ME, Toll A, Garcia A, Giavedoni P. Usefulness of High-Frequency Doppler Ultrasound in Dermatofibrosarcoma Protuberans. J Ultrasound Med 2023; 42:2171-2173. [PMID: 36916648 DOI: 10.1002/jum.16217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Affiliation(s)
| | - Agustí Toll
- Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Adriana Garcia
- Universitat de Barcelona, Barcelona, Spain
- Pathology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Priscila Giavedoni
- Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
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Zhang L, Chen H, Wang B. Dermatofibrosarcoma protuberans misdiagnosed as sebaceous adenoma and incompletely resected in a child: A case report. J Clin Lab Anal 2023; 37:e24500. [PMID: 35622689 PMCID: PMC10623525 DOI: 10.1002/jcla.24500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dermatofibrosarcoma protuberans is extremely rare in children, making a correct diagnosis by clinicians is usually difficult due to its nonspecific manifestations, the recurrence of dermatofibrosarcoma protuberans after resection has always been a perplexing problem for clinicians. Ultrasound plays an irreplaceable role in the assessment of dermatofibrosarcoma protuberans, although there is a limitation in the diagnosis of the tumor. CASE REPORT A 10-year-old boy led by his parents sought for surgical treatment because of the growing mass. Physical examination and preoperative ultrasonography showed that the mass was clear, and the routine resection of mass was performed. Six days postoperatively, histopathological examination indicated that the mass was dermatofibrosarcoma protuberans, and the peripheral and deep resection margins were positive. The patient was informed that a second extended resection was required. The second postoperative pathology showed a negative margin, and the patient was discharged. Postoperative follow-up was assessed by ultrasound examination, and the patient had no abnormalities. CONCLUSIONS Dermatofibrosarcoma protuberans should be included in the differential diagnosis when the wide base subcutaneous lesion has suspicious features with high vascularity on ultrasound. If an ultrasound reveals a mass with abundant blood flow, clinicians should routinely perform the extended resection. Wide surgical excision may reduce the risk of reoperation and recurrence, and long-term follow-up is necessary to evaluate postoperative outcomes.
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Affiliation(s)
- Liang Zhang
- Department of Radiology, The Second Clinical Medicine FacultyInner Mongolia University for NationalitiesYakeshiChina
| | - Hana Chen
- Department of Radiology, The Second Clinical Medicine FacultyInner Mongolia University for NationalitiesYakeshiChina
| | - Bin Wang
- Department of Radiology, The Second Clinical Medicine FacultyInner Mongolia University for NationalitiesYakeshiChina
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Boede M, Tillig B, Zimmermann U, Guski S, Hillen U. Hybridtumor eines Riesenzellfibroblastoms und eines Dermatofibrosarcoma protuberans. Aktuelle Dermatologie 2022. [DOI: 10.1055/a-1876-4491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
ZusammenfassungWir berichten über ein zum Zeitpunkt der Erstmanifestation 10 Monate altes Kind mit einem Hybridtumor aus Riesenzellfibroblastom (RZFB) und Dermatofibrosarkoma protuberans (DFSP). Das RZFB ist ein seltener Tumor, der mit dem DFSP die Translokation (t17;22) (q22;13) und immunphänotypische Eigenschaften teilt und daher von seinen Erstbeschreibern als kindliche Form des DFSP eingeordnet wurde. Das RZFB hat mit einer Kombination aus Spindelzellproliferaten, häufig hypozellulären Arealen mit kollagenfaserreichem oder myxoidem Stroma, sinusoid-artigen pseudovaskulären Aufweitungen zwischen den Kollagenfasern, die von multinukleären Riesenzellen umsäumt werden, jedoch ein ihm eigenes histologisches Bild. Das RZFB, das sich klinisch als langsam wachsende, i.d.R. schmerzlose Schwellung manifestiert, tritt präferentiell im Kindesalter auf. Das mittlere Erkrankungsalter liegt bei 6 Jahren. Die Therapie der Wahl ist die Exzision mit einem ausreichenden Sicherheitsabstand. Unsere junge Patientin zeigt ein Jahr nach Exzision mit 2 cm Sicherheitsabstand einen rezidivfreien Verlauf.
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Affiliation(s)
- Marcel Boede
- Klinik für Dematologie und Venerologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | - Bernd Tillig
- Klinik für Kinderchirurgie, Neugeborenenchirurgie und Kinderurologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | | | - Silja Guski
- Vivantes Pathologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | - Uwe Hillen
- Klinik für Dematologie und Venerologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
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