[Surgical treatment of dermatofibrosarcoma protuberans using wide local excision combined with Mohs micrographic surgery].

OBJECTIVE

To investigate the method and effectiveness of wide local excision combined with Mohs micrographic surgery for dermatofibrosarcoma protuberans (DFSP).

METHODS

Between January 2007 and January 2010, 17 patients with DFSP were treated. There were 9 males and 8 females with an average age of 33.2 years (range, 16-55 years). The lesions were located at head and neck (2 cases), trunk (12 cases), extremity (2 cases), and perineal region (1 case). There were 6 cases of primary DFSP and 11 cases of relapsed DFSP. The lesions presented as single or multitude nodules or fusion nodules with skin withering, scar, en plaque in the center and with ill-defined margins. The diameter of lesions ranged from 0.8 to 9.7 cm (mean, 4.3 cm). No distant metastasis or lymphatic metastasis occurred in all cases. After tumors resection by wide local excision combined with Mohs micrographic surgery, the wounds were repaired by direct suture in 3 patients, skin grafting in 9 patients, and local skin flap in 5 patients.

RESULTS

Wide local excision and Mohs micrographic surgery were carried out once in 13 patients, twice in 3 patients, and three times in 1 patient with an average operation time of 98.6 minutes (range, 56-219 minutes). Primary healing of wound and donor site were achieved with no necrosis of skin grafting and skin flap. All patients were followed up 8-34 months (mean, 21.7 months) with no recurrence.

CONCLUSION

Wide local excision combined with Mohs micrographic surgery could treat DFSP, which has the advantages of shorter operation time, radical resection, and less injury.