Dermatofibrosarcoma protuberans, a rare but locally aggressive tumor on finger: clinical and aeromedical considerations

Abstract

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow growing, locally infiltrative tumor of intermediate malignancy. It is mostly found on the trunk and head, rarely on hands. The course of evaluation and treatment of a young pilot with DFSP on left middle finger is reported. The clinical issues and aeromedical considerations of this rare tumor is discussed.

Polarized Microscopy in Lesions With Altered Dermal Collagen

“…In contrast, DFSP showed complete absence of birefringence throughout the lesion, corresponding to the crisscross collagen fibrils detected by Masson trichrome staining. 13 This characteristic absence of birefringence in DFSP could be of help in diagnosis and in delineating the tumor borders in resection specimens. A previous study including 15 cases of DFSP and 40 cases of DF, absent polarization in all cases of DFSP and 35 of 40 cases of DF was noted.…”

Recurrent Dermatofibrosarcoma Protuberant of the Hand: A Case Report

“…Most DFSPs are localized on the trunk (40% -50%), followed by proximal extremities (30% -40%), and then the head and neck (10% -15%) [3]. Infrequently documented cases have been reported on the hand [4]. The reported tumor sizes vary in a wide range from 0.5 to 10 cm in diameter, with a mean of 2 -3.5 cm [5].…”

A Rare Case of Dermatofibrosarcoma Protuberans of the Thumb in an 80-year-old Woman

“…Campos, et al [ 7 ] presented a case of myxoid DFSP on the middle finger of the left hand of a 14-year-old girl. Chiang, et al [ 1 ] reported a case of DFSP of the left middle finger in a 29-year-old pilot treated with a series of re-excisions and skin grafting. Atkinson, et al [ 8 ] presented a case with DFSP of the non-dominant ring finger of a 31-year-old police officer treated with metacarpophalangeal disarticulation.…”

“…Dermatofibrosarcoma protuberans (DFSP) has been described as a rare, slowly growing, low-grade malignancy that is locally aggressive and has a high rate of recurrence and low metastatic potential [ 1 ]. Its incidence is around four per million person-years, and it usually affects adults between 20 and 59 years of age with a slight male preponderance.…”

“…Most commonly DFSP affects the trunk (40%-50%), followed by the proximal segments of the upper and lower limbs (30%-40%) and the head and neck region (10%-15%) [ 3 ]. There are only a few cases reports of DFSP in the fingers but not in an elderly patient [ 1 ].…”