Haycox C L, Odland P B, Olbricht S M, Casey B
Division of Dermatology, University of Washington, Seattle 98195-6524, USA.
Ann Plast Surg. 1997 Mar;38(3):246-51.
Dermatofibrosarcoma protuberans (DFSP) is a relatively rare cutaneous tumor that is clinically challenging since it is locally highly invasive and aggressive, although it rarely metastasizes. Traditionally, wide and deep local surgical excision has been regarded as the treatment of choice for DFSP. However, even 3-cm-wide local excision margins have resulted in a local recurrence rate of 11%. In recent years, reports of DFSPs successfully treated with Mohs micrographic surgery have been appearing in the literature. The DFSP literature is reviewed here, including worldwide experience reported to date in the use of Mohs surgery to excise DFSPs. Using this margin control technique, the recurrence rate is shown to be 2.4%, much lower than the best previously reported recurrence rate of 11% when wide local excision was used. Three-dimensional reconstructions of DFSPs, based on Mohs micrographic surgical technique, are also presented. These illustrations provide new insight into the growth characteristics of these tumors and why Mohs micrographic surgery is emerging as the treatment of choice for DFSP.
隆突性皮肤纤维肉瘤（DFSP）是一种相对罕见的皮肤肿瘤，由于其具有局部高度侵袭性和攻击性，尽管很少发生转移，但在临床上仍具有挑战性。传统上，广泛而深部的局部手术切除一直被视为DFSP的首选治疗方法。然而，即使采用3厘米宽的局部切除边缘，局部复发率仍达11%。近年来，有关Mohs显微外科手术成功治疗DFSP的报道不断出现在文献中。本文对DFSP的文献进行了综述，包括迄今为止在全球范围内报道的使用Mohs手术切除DFSP的经验。使用这种边缘控制技术，复发率为2.4%，远低于之前报道的使用广泛局部切除时的最佳复发率11%。本文还展示了基于Mohs显微外科技术的DFSP三维重建。这些图示为这些肿瘤的生长特征以及Mohs显微外科手术为何正在成为DFSP的首选治疗方法提供了新的见解。
