Case of pleomorphic dermal sarcoma with systematic review of disease characteristics, outcomes and management

Pleomorphic Dermal Sarcoma: a case report

“…In a series of 32 reported cases of PDS, tumor necrosis was evidenced in 53% of patients; lymphovascular invasion in 26%; perineural invasion in 29%; the presence of positive CD10 in 100% of the cases and a metastatic rate of 10%.9 In the presented case, the involvement of the deep subcutaneous and fascia, as well as the perineural invasion, favors the diagnosis of PDS. Lo et al [7] recently performed a systematic PubMed search on "pleomorphic dermal sarcoma" and found 15 longitudinal studies that provided results specific to PDS. They discovered through meta-analysis and statistical tests that PDS: primarily affects older individuals, predominantly men (82.80%, 95% CI=72.37% to 89.95%, I2=62.1%, likelihoodratio test p=0.011); is largely found on the scalp (68.92%, 95% CI=57.99% to 78.08%, I2=54.9%, p=0.019) or the face (13.05%, 95% CI=4.16% to 34.18%, I2=88.1%, p<0.0001); recurrence rate was 23.80% (95% CI=17.97% to 30.82%, I2=11.5%, p=0.037) and metastasis was 7.14% (95% CI=4.55% to 11.05%, I2=0%, 0.261) [7].…”

“…Lo et al [7] recently performed a systematic PubMed search on "pleomorphic dermal sarcoma" and found 15 longitudinal studies that provided results specific to PDS. They discovered through meta-analysis and statistical tests that PDS: primarily affects older individuals, predominantly men (82.80%, 95% CI=72.37% to 89.95%, I2=62.1%, likelihoodratio test p=0.011); is largely found on the scalp (68.92%, 95% CI=57.99% to 78.08%, I2=54.9%, p=0.019) or the face (13.05%, 95% CI=4.16% to 34.18%, I2=88.1%, p<0.0001); recurrence rate was 23.80% (95% CI=17.97% to 30.82%, I2=11.5%, p=0.037) and metastasis was 7.14% (95% CI=4.55% to 11.05%, I2=0%, 0.261) [7]. Among four of the studies analyzed, local recurrences were due to incomplete removal or inadequate margins [7].…”

“…The evolution and prognosis of PDS are reserved, 20 to 30% of patients have local recurrence, with an average time for recurrence of 10 months, and 10 to 20% have distant metastases to the skin, lymph nodes and/or lungs [2,4,6,9]. The presence of metastatic disease is associated with an increased mortality rate [7,9,11]. The present case report draws attention to the importance of including PDS as one of the differential diagnoses in the investigation of skin tumors, specially of the scalp, in elderly patients with pronounced photodamaged.…”

“…PDS lesions appear on the face and scalp of elderly male patients (mean age of 81 years old) with accentuated photodamage [7]. They are characterized by rapidly growing nodules or infiltrated plaques, often larger than 2 cm, and may progress to ulceration and bleeding [1,5,8,9].…”

Oncological Safety and Recurrence in the Surgical Treatment of Atypical Fibroxanthoma and Pleomorphic Dermal Sarcoma of the Scalp

“…In line with previously published data, we report no recurrence of AFX nor distant metastasis in any patient after complete excision [ 7 , 29 , 30 ]. The recurrence rates of PDS on the scalp were previously described by a meta-analysis of nine studies as 23.8%, with a local recurrence of 19.92% and metastasis in 7.14% of all cases over a mean follow-up of 13–46.4 months [ 31 ]. The analyzed subgroup of patients with satellite metastasis of PDS in this study aligns with this data.…”