DERMATOFIBROSARCOMA PROTUBERANS TREATED WITH MOHS MICROGRAPHIC SURGERY - CURE RATES AND SURGICAL MARGINS

BACKGROUND. Dermatofibrosarcoma protuberans is an uncommon malignant t umor of the skin with a frequent tendency to recur after standard surg ical excision. This study assesses the degree of subclinical tumor ext ension and evaluates the cure rate and tissue conservation abilities o f Mohs micrographic surgery. METHODS. Twenty-four patients with dermat ofibrosarcoma protuberans underwent Mohs micrographic surgery. Surgica l margins and clinical outcome were evaluated and compared with the re sults of standard surgical treatment in the medical literature. RESULT S. Twenty-six Mohs micrographic surgical procedures were performed on 24 patients. Eighty-five percent of the procedures were microscopicall y cleared with 2.5-cm margins, 69% with 2.0-cm margins, 50% with 1.5-c m margins, and 35% with 1.0-cm margins. Two tumors would have been ina dequately excised if standard 3-cm margins had been used. The assessme nt of tissue conservation revealed a mean of 43.0 cm(2) of tissue spar ed in a subset of seven tumors in functionally or cosmetically critica l locations. Two tumors were recurrent following MMS and are detailed as case reports. CONCLUSION. The variability of subclinical tumor exte nsion in dermatofibrosarcoma protuberans is confirmed. The ability of Mohs micrographic surgery to minimize surgical margins, preserve cosme tically and functionally vital tissue, and yield high cure rates is co nfirmed.