Otani Satoshi, Ishii Hiroshi, Hashinaga Kazuhiko, Morinaga Ryotaro, Umeki Kenji, Kishi Kenji, Shirai Ryo, Tokimatsu Issei, Hiramatsu Kazufumi, Kawahar Katsunobu, Kadota Jun-ichi
Department of Infectious Diseases, Oita University Faculty of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2008 Mar;46(3):253-7.
A 63-year-old man had undergone excision of a growing mass with a wide margin in the left supraclavicular fossa. A diagnosis of fibrosarcomatous variant of dermatofibrosarcoma protuberans (DFSP-FS) was made. Three years later, an abnormal chest shadow was detected on a medical checkup. Chest computed tomography showed a heterogeneously-enhanced 2-cm coin lesion with a distinct border in the right lower lobe and a 3-mm nodule in the left lower lobe. Transbronchial lung biopsy specimens from the right lung revealed a DFSP pattern. We then performed right basal segmentectomy and partial resection of the left lower lobe. DFSP is a relatively rare skin tumor that is considered to be intermediate malignancy. It frequently recurs locally but rarely has systemic metastasis. However, DFSP-FS, a subtype of DFSP, has an increased likelihood of systemic metastasis. The lung is the most common site of metastasis of DFSP-FS. DFSP-FS sometimes recurs even a long time after excision. Therefore, long-term follow-up, including chest X-ray and CT are important in DFSP-FS patients.
一名63岁男性在左锁骨上窝对一个不断增大的肿块进行了广泛切缘切除。诊断为隆突性皮肤纤维肉瘤的纤维肉瘤样变体（DFSP-FS）。三年后，体检时发现胸部有异常阴影。胸部计算机断层扫描显示右肺下叶有一个边界清晰、大小为2厘米的不均匀强化类圆形病灶，左肺下叶有一个3毫米的结节。右肺经支气管肺活检标本显示为DFSP模式。然后我们进行了右肺基底段切除术和左肺下叶部分切除术。DFSP是一种相对罕见的皮肤肿瘤，被认为是中间恶性肿瘤。它经常局部复发，但很少有全身转移。然而，DFSP的亚型DFSP-FS发生全身转移的可能性增加。肺是DFSP-FS最常见的转移部位。DFSP-FS有时甚至在切除后很长时间仍会复发。因此，对DFSP-FS患者进行包括胸部X线和CT在内的长期随访很重要。
