DERMATOFIBROSARCOMA PROTUBERANS (DFSP) - GROWTH-CHARACTERISTICS BASEDON TUMOR MODELING AND A REVIEW OF CASES TREATED WITH MOHS MICROGRAPHIC SURGERY

Dermatofibrosarcoma protuberans (DFSP) is a relatively rare cutaneous tumor that is clinically challenging since it is locally highly invasi ve and aggressive, although it rarely metastasizes. Traditionally, wid e and deep local surgical excision has been regarded as the treatment of choice for DFSP. However, even 3-cm-wide local excision margins hav e resulted in a local recurrence rate of 11%, in recent years, reports of DFSPs successfully treated with Mohs micrographic surgery have bee n appearing in the literature. The DFSP literature is reviewed here, i ncluding worldwide experience reported to date in the use of Mohs surg ery to excise DFSPs. Using this margin control technique, the recurren ce rate is shown to be 2.4%, much lower than the best previously repor ted recurrence rate of 11% when wide local excision was used, Three-di mensional reconstructions of DFSPs, based on Mohs micrographic surgica l technique, are also presented, These illustrations provide new insig ht into the growth characteristics of these tumors and why Mohs microg raphic surgery is emerging as the treatment of choice for DFSP.