2023 World Conference on Lung Cancer (Posters)-EP14.03. Pulmonary Metastastasis of Dermatofibrosarcoma Protuberans of the Scalp : A Challenging Mesenchymal Tumor

EP14.03. Pulmonary Metastastasis of Dermatofibrosarcoma Protuberans of the Scalp : A Challenging Mesenchymal Tumor - PDF(Slides)

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Dermatofibrosarcoma protuberans (DFSP) is a rare slow-growing soft tissue sarcoma of the skin. While it often recurs locally, metastasis is rare. We present a case of a 31-year-old female with pulmonary metastasis of a local recurrence of DFSP in the scalp. The patient had undergone multiple surgeries and reconstructions for local recurrences. In November 2022, she developed shortness of breath and cough, and lung metastases were diagnosed. Surgery was performed to remove a large mass in the left inferior lobes of the lung. Pathological examination revealed a malignant mesenchymal tumor. The surgical margins were negative, and the patient is currently being followed by surgical oncology with plans for possible repeat chemotherapy.<br /><br />DFSP is a fibrohistiocytic tumor with locally aggressive behavior. It typically occurs in early to middle age and can be found on various parts of the body. Metastasis occurs in less than 5% of cases, and lung metastases are uncommon. In this case, lung metastases developed 5 years after the initial surgery and previous local recurrence. We highlight the importance of careful evaluation and management of patients with distant metastases in the presence of local recurrence.<br /><br />The recommended treatment for DFSP is wide local excision with a margin of at least 2 cm. Mohs micrographic surgery has also shown favorable outcomes. Follow-up after surgery is advised for a minimum of three years, with regular intervals to detect any local recurrences. Radiotherapy and chemotherapy with selective tyrosine kinase inhibitors, such as imatinib mesylate, may also be beneficial.<br /><br />In conclusion, DFSP is a challenging tumor with a low incidence of metastasis. This case emphasizes the need for thorough evaluations and monitoring to detect distant metastases in the presence of local recurrence. Wide local excision and Mohs micrographic surgery are recommended treatment options, and radiotherapy and chemotherapy may also be beneficial.

Asset Subtitle

Ananda Aulia

Meta Tag

Speaker Ananda Aulia

Topic Other Thoracic Malignancy

Keywords

Dermatofibrosarcoma protuberans

DFSP

soft tissue sarcoma

skin tumor

pulmonary metastasis

local recurrence

surgical oncology

wide local excision

Mohs micrographic surgery

tyrosine kinase inhibitors