Department of Dermatology, Eberhard Karls University of Tübingen, DE-72076 Tuebingen, Germany. E-mail:
Acta Derm Venereol. 2021 Sep 28;101(9):adv00561. doi: 10.2340/00015555-3915.
Removal of the deep fascia is recommended in therapy for dermatofibrosarcoma protuberans, but its necessity in the context of micrographic surgery is unclear. A retrospective clinicopathological analysis of 48 patients with dermatofibrosarcoma protuberans treated by micrographic surgery was performed, to determine in which tumours fascia preservation was feasible and safe. Histologically, 93% of tumours on the trunk and extremities and 14% of tumours in the head and neck region were fully located above the fascia. Localization on the head and neck was the only significant risk factor for tumour extension beyond the subcutis (p<0.001). Overall, 44% of tumours were completely excised above the fascia and 56% with deeper excisions. Two deeply infiltrating tumours (4%) on the head recurred, but in none of these lesions was the fascia spared. These results show that micrographic surgery allows fascia preservation in superficial tumours outside the head and neck region.
在隆突性皮肤纤维肉瘤的治疗中，建议切除深部筋膜，但在显微手术中其必要性尚不清楚。对 48 例接受显微手术治疗的隆突性皮肤纤维肉瘤患者进行了回顾性临床病理分析，以确定在哪些肿瘤中保留筋膜是可行和安全的。组织学上，躯干和四肢的 93%肿瘤和头颈部的 14%肿瘤完全位于筋膜上方。头颈部定位是肿瘤超出皮下组织延伸的唯一显著危险因素（p<0.001）。总体而言，44%的肿瘤完全切除在筋膜上方，56%的肿瘤切除较深。2 例位于头部的深部浸润性肿瘤（4%）复发，但在这些病变中均未保留筋膜。这些结果表明，显微手术允许在头颈部以外的浅表肿瘤中保留筋膜。
