Dermatofibrosarcoma protuberans growing around plantar aponeurosis: Excision by Mohs micrographic surgery

BACKGROUND. Dermatofibrosarcoma protuberans (DFSP) is a spindle cell malign ancy that has a high local recurrence rate after excision with minimal or n o immediate tissue margin assessment. DFSP is exceedingly rare on the palms and soles. OBJECTIVE. TO report a case of a locally aggressive DFSP on the sole excise d using Mobs micrographic surgery. METHODS. Case report and review of the literature. RESULTS. Mohs micrographic surgery unmasked tumor infiltration that extende d around plantar aponeurosis and into underlying plantar muscle fascia. CONCLUSION. Mohs micrographic surgery should be considered the treatment of choice for DFSP, especially in acral locations. This technique allows the surgeon to trace out deep tumor extensions that may wrap around underlying tendon, a finding that may not be appreciated clinically.