Oge Tufan, Benedicic Christoph, Tamussino Karl, Regauer Sigrid
Agrı Kadin Dogum ve Cocuk Hastanesi, Agri, Turkey.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.07.2008.0377. Epub 2009 Mar 5.
Dermatofibrosarcoma protuberans (DFSP) is a low-grade to intermediate-grade well-differentiated sarcoma of dermal origin. Local recurrence rates are high but distant metastases are rare. This report describes a case of vulvar DFSP requiring four resections for primary clearance. A 56-year-old woman referred after excision of a vulvar tumour and histology had DFSP extending to the resection margins. Two more extended excisions again yielded a specimen with positive margins. The last excision was performed with intraoperative frozen section analysis of the margins. Frozen section analysis of the resected specimen revealed clear margins and this was confirmed by final pathology. The postoperative course was uneventful. The patient has been without recurrence for 15 months. A wide and deep local excision is recommended for both primary and recurrent lesions. The patient had three resections before clear surgical margins were achieved. Intraoperative frozen section analysis is helpful in assessing resection margins.
隆突性皮肤纤维肉瘤（DFSP）是一种起源于真皮的低级别至中级别、分化良好的肉瘤。局部复发率高，但远处转移罕见。本报告描述了一例需要进行四次切除以实现原发灶清除的外阴DFSP病例。一名56岁女性在外阴肿瘤切除术后转诊，组织学检查显示DFSP已延伸至切除边缘。另外两次扩大切除后，标本边缘仍为阳性。最后一次切除术中对边缘进行了冰冻切片分析。切除标本的冰冻切片分析显示边缘清晰，最终病理证实了这一点。术后过程顺利。患者已无复发15个月。对于原发性和复发性病变，建议进行广泛而深入的局部切除。该患者在获得清晰的手术切缘之前进行了三次切除。术中冰冻切片分析有助于评估切除边缘。
