Martín-Fuentes Adriana, De Eusebio-Murillo Esther, Herreros Consuelo Sánchez, Ballano-Ruiz Adrian, Blázquez Esther Jiménez, Cuevas-Santos Jesús
Department of Dermatology, Hospital Universitario de Guadalajara, Guadalajara, Spain.
Department of Pathology, Hospital Universitario de Guadalajara, Guadalajara, Spain.
Indian J Dermatol Venereol Leprol. 2018 May-Jun;84(3):298-303. doi: 10.4103/0378-6323.190853.
Dermatofibrosarcoma protuberans is a rare malignant tumor with a high rate of recurrence after surgery. Moh's micrographic surgery allows examination of all surgical margins to ensure complete removal.
To evaluate the use of Moh's micrographic surgery using paraffin-embedded sections for the treatment of dermatofibrosarcoma protuberans.
We performed a retrospective analysis of 33 patients with dermatofibrosarcoma protuberans treated in our department with paraffin-embedded micrographic surgery between January 2002 and June 2015. Our cases included patients with primary untreated disease and also those with persistent disease previously treated surgically elsewhere, with histologically positive margins.
Tumors were most commonly located on the trunk. After the first stage of micrographic surgery, including an initial lateral margin, 20 (60.6%) tumors were completely excised, 11 (33.3%) tumors required two stages and one tumor each (3.0%) required 4 and 6 stages respectively. Patients were monitored for recurrence for a mean duration of 6.5 years. There was no recurrence in any of our 33 patients.
Our results indicate that Moh's micrographic surgery with paraffin-embedded sections may be the method of choice to treat dermatofibrosarcoma protuberans with a low recurrence rate, while preserving surrounding normal healthy tissue.
隆突性皮肤纤维肉瘤是一种罕见的恶性肿瘤，术后复发率高。莫氏显微外科手术可检查所有手术切缘以确保完整切除。
评估使用石蜡包埋切片的莫氏显微外科手术治疗隆突性皮肤纤维肉瘤的效果。
我们对2002年1月至2015年6月期间在我科接受石蜡包埋显微外科手术治疗的33例隆突性皮肤纤维肉瘤患者进行了回顾性分析。我们的病例包括未经治疗的原发性疾病患者以及先前在其他地方接受过手术治疗、组织学切缘阳性的持续性疾病患者。
肿瘤最常见于躯干。在显微外科手术的第一阶段，包括初始的外侧切缘，20例（60.6%）肿瘤被完全切除，11例（33.3%）肿瘤需要两个阶段，各有1例（3.0%）肿瘤分别需要4个和6个阶段。对患者进行了平均6.5年的复发监测。我们的33例患者均未复发。
我们的结果表明，使用石蜡包埋切片的莫氏显微外科手术可能是治疗隆突性皮肤纤维肉瘤的首选方法，复发率低，同时保留周围正常健康组织。
