Garcia C, Clark R E, Buchanan M
Dermatologic Surgery and Cutaneous Oncology Unit, Duke University Medical Center, Durham, NC 27710, USA.
Int J Dermatol. 1996 Dec;35(12):867-71. doi: 10.1111/j.1365-4362.1996.tb05053.x.
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive soft tissue sarcoma in which recurrences are common. It usually affects middle-aged individuals with the most common location being the trunk. Sex distribution varies among published series. Mohs surgery is the treatment of choice. Immunostaining for CD34 facilitates the diagnosis of DFSP and aids in indicating the surgical margins of the tumor; however, the sensitivity of this marker is variable.
This is a retrospective review of 16 cases of DFSP treated with Mohs surgery at Duke University Medical Center between 1981 and 1994. Clinical and histologic features are analyzed. Immunohistochemical stains for CD34 were performed in one case.
Twelve of the 16 patients were women with four younger than 20 years. The most common location was the trunk. No recurrences following Mohs surgery have been documented. The average number of stages during Mohs surgery was 3.3. Surgical wounds were repaired by complex layered closure in 11 cases. Stains for CD34 were negative on the initial biopsy, but were positive on frozen sections.
Both sexes and all age groups are affected by DFSP. Mohs surgery is the treatment of choice and offers a significant improvement in cure rates with the cosmetic advantage of smaller postoperative wounds. Immunostains for CD34 appear to be an important adjunct to facilitate tumor removal, but the variable expression of CD34 antigen by DFSP tumors can lead to variable staining patterns.
隆突性皮肤纤维肉瘤（DFSP）是一种局部侵袭性软组织肉瘤，复发很常见。它通常影响中年人，最常见的部位是躯干。已发表系列研究中的性别分布有所不同。莫氏手术是首选治疗方法。CD34免疫染色有助于DFSP的诊断，并有助于确定肿瘤的手术切缘；然而，该标志物的敏感性存在差异。
这是一项对1981年至1994年间在杜克大学医学中心接受莫氏手术治疗的16例DFSP病例的回顾性研究。分析了临床和组织学特征。对1例进行了CD34免疫组织化学染色。
16例患者中有12例为女性，4例年龄小于20岁。最常见的部位是躯干。尚无莫氏手术后复发的记录。莫氏手术期间的平均阶段数为3.3。11例手术伤口通过复杂分层缝合修复。CD34染色在初始活检时为阴性，但在冰冻切片上为阳性。
DFSP可累及男女各年龄组。莫氏手术是首选治疗方法，治愈率显著提高，且具有术后伤口较小的美容优势。CD34免疫染色似乎是促进肿瘤切除的重要辅助手段，但DFSP肿瘤中CD34抗原的可变表达可导致可变的染色模式。
