Wide Excision or Mohs Micrographic Surgery for the Treatment of Primary Dermatofibrosarcoma Protuberans

Abstract

From a surgical standpoint, WE was faster than MMS and resulted in a less complex defect/closure. Although positive margin resection was more common with WE, local control was ultimately similar for the 2 surgical modalities. The choice of WE versus MMS should be based on individualized patients/tumor characteristics and institutional expertise in these modalities.

Multidisciplinary approach to the management of dermatofibrosarcoma protuberans

“…Conversely, obtaining negative lateral margins is more difficult with WLE compared with MMS, as the neoplastic projections in DFSP can extend up to 3 cm beyond clinically visible borders of the lesion. [11][12][13] A multidisciplinary approach to DFSP has been described for select lesions (ie, head and neck) not amendable to WLE or MMS alone. Although this multidisciplinary approach has been associated with favorable recurrence rates and reconstructive outcomes, there have been few reports exclusively using this method for the management of all DFSP lesions.…”

Malignant cutaneous adnexal tumours of the head and neck: an update on management

“…29 Meguerditchian et al found higher rates of recurrence after wide excision than after MMS, but the difference was not significant because the numbers were too low. 30 Chaput et al found that with MMS, most patients needed one operation (72%) with median clinical excision margins of 17 mm, and only direct closure was required. 31 They particularly advocated the technique for lesions on the head and neck as it is essential to spare as much tissue as possible.…”

Current approaches to cutaneous sarcomas: Dermatofibrosarcoma protuberans and cutaneous leiomyosarcoma

“…26,54 The concept of completely evaluating the deep and circumferential margins during MMS cannot be overstated and obviously greatly decreases the recurrence rate. 26 There is a role for MMS in treating LMS and DFSP at certain anatomic sites such as the face, hands, and feet, in order to conserve tissue, improve cosmetic deformity, as well as limit functional deficit/morbidity.…”