Dermatofibrosarcoma on a postoperative scar

Hind Palamino, Siham Belmourida, Fatima Azzahra El Ghaitibi, Mariame Meziane, Nadia Ismaili, Laila Benzekri, Karima Senouci

Dermatology-Venereology Department,CHU Ibn Sina, Rabat, Morroco

Corresponding author: Hind Palamino, MD

Submission: 07.11.2020; Acceptance: 10.01.2021

DOI: 10.7241/ourd.2021e.22

Cite this article: Palamino H, Belmourida S, El Ghaitibi FA, Meziane M, Ismaili N, Benzekri L, Senouci K. Dermatofi brosarcoma on a postoperative scar. Our Dermatol Online. 2021;12(e):e22.

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A 37-year-old patient, operated for an umbilical hernia 5 years ago, who presented for a supra-umbilical lesion evolving for more than 2 years, the dermatological examination revealed an erythematous-violaceous lesion, multinodular, measuring 4 centimeters in diameter, painless, and firm on a the scar of the cure of his hernia (Fig. 1).

Figure 1: Erythematous-purplish nodules, form on a post-surgical scar.

Skin biopsy and immunohistochemistry revealed a spindle cell tumor evoking a Darier and Ferrant dermatofibrosarcoma, the anti CD34 was positive, and the PS100 was negative.

The standard biological assessment was normal, The thoracic – abdominal and pelvic tomodensitometry revealed a left umbilical mass with infiltration of the rectus abdominis muscle, the patient benefited a large resection.

Darier and Ferrand dermatofibrosarcoma is a rare mesenchymal tumor described in 1924 by Jean Darier and Marcel Ferrand, it represents 0.1% of malignant skin tumors and less than 5% of sarcomas, It sits on the trunk, proximal extremities, neck and head. It often affects young adults between the 3rd and 4th decade [1,2].

The notion of anterior trauma is found in 10 to 20% of cases, Some authors have mentioned exogenous factors in its occurrence such as scars from burns, vaccination, radiotherapy, traumatized nevi, syphilitic lesions, and microtrauma.

Its clinical aspects are misleading, it can manifested in the form of an infiltrated plaque, a nodule, or a multinodular lesion, lesions may suggest a keloid scar which is the main differential diagnosis [1,3,4].

Histologically, the diagnosis is essentially morphological and poses a diagnostic problem with other spindle cell tumors, hence the importance of immunohistochemistry and particularly anti-CD34. It’s characterized by its slow growth, and low metastatic potential, but at high risk of local recurrence. The prognosis is good if the resection of the tumor is complete [1,2].

The interest of our observation lies in the rarity of this entity and its occurrence on a post-surgical scar.

Consent

The examination of the patient was conducted according to the principles of the Declaration of Helsinki.

The authors certify that they have obtained all appropriate patient consent forms, in which the patients gave their consent for images and other clinical information to be included in the journal. The patients understand that their names and initials will not be published and due effort will be made to conceal their identity, but that anonymity cannot be guaranteed.

REFERENCES

1. Frikha F, Mseddi M, Bahloul E, Chaabouni R, Masmoudi A, Boudaya S, et al. [Dermatofibrosarcoma protuberans (Report of 49 cases)]. Our Dermatol Online. 2020;11:25-31.

2. Hammas N, Badioui I, Znati K, Benlemlih A, Chbani L, El Fatemi H, et al. Dermatofibrosarcoma protuberans:report of 27 cases and review of the literature. Pan Afr Med J. 2014;18:280.

3. Reha J, Katz SC. Dermatofibrosarcoma Protuberans. Surg Clin North Am. 2016;96:1031–46.

4. Elamrani D, Droussi H, Boukind S, Elatiqi K, Dlimi M, Benchamkha Y, et al. Dermatofibrosarcoma protuberans, particular skin tumor:report of 32 cases and review of the literature. Pan Afr Med J. 2014;19:196.

Notes

Source of Support: Nil,

Conflict of Interest: None declared.