Dermatological Surgery and Laser Unit, St John's Institute of Dermatology, St Thomas' Hospital, London SE1 7EH, UK.
Br J Dermatol. 2011 Feb;164(2):363-6. doi: 10.1111/j.1365-2133.2010.10095.x.
Dermatofibrosarcoma protuberans (DFSP) has conventionally been treated with wide local excision. More recently Mohs micrographic surgery (MMS) has been advocated.
To assess our departmental experience with DFSP in the context of a literature review relating to DFSP treated with MMS.
This was a case review of 35 patients with DFSP treated between 1998 and 2009 with MMS using paraffin-embedded sections.
Seventeen patients required one horizontal layer to clear their tumour, 10 patients needed two and eight patients needed three layers or more. The median preoperative clinical size was 6 cm(2) (range 0·75-54·8) and the median postoperative wound size was 46·8 cm(2) (range 4-145·2). Tumour persistence has not been observed in any of our patients after a median follow-up duration of 29·5 months (range 6-146).
We present 35 DFSP patients, none of whom showed persistent tumour after treatment with 'slow' MMS using paraffin sections. We advocate MMS as the treatment of choice for DFSP, especially for tumours over the head and neck region where tissue conservation is particularly important.
隆突性皮肤纤维肉瘤（DFSP）传统上采用广泛局部切除术进行治疗。最近，Mohs 显微外科手术（MMS）被提倡使用。
在与 MMS 治疗 DFSP 相关的文献综述背景下，评估我们科室治疗 DFSP 的经验。
这是一项回顾性病例研究，共纳入 35 例于 1998 年至 2009 年间采用石蜡切片行 MMS 治疗的 DFSP 患者。
17 例患者只需一个水平层即可清除肿瘤，10 例患者需要两个层，8 例患者需要三个层或更多层。术前临床大小中位数为 6cm²（范围 0.75-54.8），术后伤口大小中位数为 46.8cm²（范围 4-145.2）。在中位随访 29.5 个月（范围 6-146）后，我们所有患者的肿瘤均无持续存在。
我们报告了 35 例 DFSP 患者，采用石蜡切片的“缓慢”MMS 治疗后，无一例患者的肿瘤持续存在。我们提倡将 MMS 作为 DFSP 的治疗选择，尤其是在头颈部区域，组织保存尤为重要。
