FNAC in the diagnosis of recurrent dermatofibrosarcoma protuberans of the forehead - A case report

BACKGROUND: Dermatofibrosarcoma protuberans is a rare cutaneous soft tissue tumor of intermediate malignant potential with a characteristic tendency f or recurrence. Metastases are un usual. This tumor usually occurs in the tr unk and extremities and, infrequently, on the face and scalp. Its cytologic appearance on fine needle aspiration has only been rarely reported. It is characterized by numerous fibroblastlike cells that arrange as single cells or in clusters of spindle cells arrayed in a storiform pattern. CASE: A 42-year-old male presented with a one-year history of an enlarging left forehead mass (lateral brow) that was adjacent to an old surgical scar . Fine needle aspiration revealed a low grade spindle cell neoplasm morphol ogically identical to a dermatofibrosarcoma protuberans excised 15 years ea rlier, indicating turner recurrence. CONCLUSION: Distinguishing dermatofibrosarcoma protuberans from other spind le cell tumors and fibrohistiocytic lesions may pose significant challenges to the pathologist. However, in the appropriate clinical setting and apply ing strict diagnostic criteria, fine needle aspiration cytology is a reliab le tool in establishing the diagnosis of this neoplasm.