Xiang Qingtian, Lu Wanqing, He Xing, Li Hua
Department, Xiangshui People's Hospital, Xiangshui Jiangsu 224600, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Nov;25(11):1350-3.
To investigate the method and effectiveness of wide local excision combined with Mohs micrographic surgery for dermatofibrosarcoma protuberans (DFSP).
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.
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.
Wide local excision combined with Mohs micrographic surgery could treat DFSP, which has the advantages of shorter operation time, radical resection, and less injury.
探讨广泛局部切除联合莫氏显微描记手术治疗隆突性皮肤纤维肉瘤（DFSP）的方法及疗效。
2007年1月至2010年1月，对17例DFSP患者进行治疗。其中男性9例，女性8例，平均年龄33.2岁（范围16 - 55岁）。病变位于头颈部（2例）、躯干（12例）、四肢（2例）和会阴区（1例）。原发性DFSP 6例，复发性DFSP 11例。病变表现为单个或多个结节或融合结节，伴有皮肤萎缩、瘢痕，中央呈斑块状，边界不清。病变直径0.8～9.7 cm（平均4.3 cm）。所有病例均未发生远处转移或淋巴转移。采用广泛局部切除联合莫氏显微描记手术切除肿瘤后，3例患者伤口直接缝合，9例患者行植皮术，5例患者行局部皮瓣修复。
13例患者广泛局部切除及莫氏显微描记手术进行1次，3例患者进行2次，1例患者进行3次，平均手术时间98.6分钟（范围56 - 219分钟）。伤口及供区一期愈合，植皮及皮瓣无坏死。所有患者随访8～34个月（平均21.7个月），无复发。
广泛局部切除联合莫氏显微描记手术可治疗DFSP，具有手术时间短、切除彻底、损伤小等优点。
