A Rare Case of Dermatofibrosarcoma Protuberans Over Interscapular Region : A Case Report

Introduction: Dermatobrosarcoma protuberans (DFSP) is a rare cutaneous tumour, a soft tissue sarcoma commonly seen on the trunk and proximal extremities1. DFSP accounts for less than 0.1% of all tumours, but it is the most common skin sarcoma ( nearly 1% of all soft tissue sarcomas), accounts for more than 1% of all head and neck malignant tumours, and 7% of all head and neck sarcomas. It arises most commonly from the dermis1, typically appears as a slow growing progressive tumour and rarely metastasise2. Treated with wide local excision and Mohs micrographic surgery. DFSP has a high rate of local recurrence even after excision however it has a low metastatic potential. Purpose of the study is to report such a rare case for better understanding and management. A 39 yo male presented with a s Description Of Case: welling over the interscapular region with a history of increase in the size of the swelling over a period of 6 months. He had a history of similar swelling at the same site 6 months back, diagnosed as lipoma ( conrmed on FNAC ) for which excision was done under local anaesthesia. Histopathological examination revealed DFSP and patient was advised regular follow up. However patient came to OPD only after 6 months with the present complaint of similar swelling at the same site. There was no history of weight loss or appetite loss, fever, chills or night sweats. Patient reported no known comorbidities or trauma history in the past. Local examination revealed a painless, rm, well circumscribed oval swelling ~ 8 x 7 cm over the interscapular region with no signs of warmth or redness. Slightly mobile in all directions. Not xed to the underlying muscles. Skin over the swelling is normal. There were no lymphadenopathy or any signicant history for malignancy. Ultrasound (USG) revealed a well-dened hypoechoic lesion in the subcutaneous layer. An USG-guided ne needle aspiration cytology (FNAC) revealed a spindle cell neoplasm of low grade. Wide local excision of the tumour was performed. Histopathological examination revealed high cellularity proliferating spindle cells arranged in storiform and whorled pattern, involving dermis and inltrating into subcutaneous adipose tissue with honeycomb pattern. Tumour cells have mild nuclear pleomorphism, inconspicuous nucleoli and eosinophilic cytoplasm with foci of necrosis. Immunohistochemistry showed cells positive for CD-34, negative for STAT6 and Ki67 of 4%. All reports conrmed Dermatobrosarcoma Protuberans. The present Conclusion: study documented a rare case of DFSP over interscapular region in Imphal region of India. Due to the high likelihood of recurrence, it is crucial to monitor these patients for an extended period of time.