Intracranial extension of a dermatofibrosarcoma protuberans of the scalp:

Imaging Findings of Head and Neck Dermatofibrosarcoma Protuberans

“…Although none of the lesions in our series showed intracranial extension, this has been described in 2 case reports. 10,17 None of the patients in our series had local or nodal metastasis, perineural spread, or bone destruction. In contrast, 2-3% of all patients with squamous cell carcinoma of the skin have metastasis, which occurs almost exclusively through lymphatic channels and only rarely through hematogenous spread.…”

“…9 Previously published reports on DFSP have highlighted its clinical features, but only a few small series have outlined its imaging features. 7,8,10 The purpose of this study was to more comprehensively define the CT and MR imaging appearance of DFSP of the head and neck.…”

Malignant cutaneous tumors of the scalp: A study of demographic characteristics and histologic distributions of 398 Taiwanese patients

“…[14][15][16][17][18][19][20][21] Basal and squamous cell carcinomas, angiosarcoma, and dermatofibrosarcoma protuberans can have aggressive and destructive behaviors; invade beyond the periosteum, skull bone, dura, and even brain; and result in profound morbidity and mortality. [22][23][24][25][26][27][28][29][30] In advanced scalp tumors with deep and extensive invasion, an interdisciplinary approach is required to excise tumors completely, reconstruct massive surgical defects successfully, and improve cure rates significantly. 3,31-35…”

Management of Scalp Dermatofibrosarcoma Protuberans

“…The stroma contains hyaluronic acid and appears to be pale basophic to clear, staining positive for alcian blue (Figure 2B). 5,16 The histologic diagnosis and the possible extent of tumor involvement are often challenging 15 . DFSP exhibiting hemorrhagic foci may also resemble aggressive vascular neoplasms and may carry a higher metastatic potential 17…”

“…The locally invasive nature of DFSP scalp tumors can lead to bony erosion and even invasion into the brain, especially with recurrent tumors 4 . Multiple previous treatments of DFSP increase the risk of tumor metastases 5 …”