Dermatofibrosarcome protuberans récidivant du sein: à propos d’un cas
Tóm tắt
The dermatofibrosarcoma protuberans (DFSP) is a sarcoma of low rank developing slowly from the fibroblasts of the dermis. The main characteristic of this tumour is its big potential for local recurrence. We report the case of a patient aged 44 presenting a DFSP of the breast that relapsed on two occasions. The remaining extension was negative. She benefited from a large timorous excision. The mammary localization of a DFSP is rare. The diagnosis is difficult. The therapeutic objective of DFSP is to reach a possible most complete surgical resection; the conventional surgical excision must let healthy margins (of 3 to 5 cm) with the inconvenience of the substance loss. The technique of Moh, verifying the limits of excision in preoperative, can palliate this inconvenience. The risk of recurrence is low when the resection margins are healthy. Radiotherapy as adjuvant treatment is very useful when the margins are not sufficient. The surveillance must be prolonged.
Tài liệu tham khảo
Lee SJ, Mahoney MC, Shaughnessy E (2009) Dermatofibrosarcoma protuberans of the breast: imaging features and review of the literature. Am J Roentgenol 193(1):64–69
Lin JY, Sheen-Chen SM, Hsu W, et al (2008) Dermatofibrosarcoma protuberans of the breast. Tumori 94(6):861–863
Arnaud EJ, Perrault M, Revol M, et al (1997) Surgical treatment of dermatofibrosarcoma protuberans. Plas Reconst Surg 100: 884–895
Ramakrishnan V, Shoher A, Ehrlich M, et al (2005) Atypical dermatofibrosarcoma protuberans in the breast. Breast J 11(3):217–218
Mentzel T, Beham A, Katenkamp D, et al (1998) Fibrosarcomatous (“high-grade”) dermatofibrosarcoma protuberans: clinicopathologic and immunohistochemical study of a series of 41 cases with emphasis on prognostic significance. Am J Surg Pathol 22(5): 576–587
Cavusoglu T, Yavuzer R, Tuncer S (2003) Dermatofibrosarcoma protuberans of the breast. Aesthetic Plast Surg 27(2):104–106
Valli R, Rossi G, Natalini G, Losi L (2002) Dermatofibrosarcoma protuberans of the breast: a case report. Pathologica 94(6):310–313
Blanchard DK, Reynolds CA, Grant CS, Donohue JH (2003) Primary nonphylloides breast sarcomas. Am J Surg 186(4): 359–361
Wick MR, Ritter JH, Lind AC, Swanson PE (1999) The pathological distinction between deep penetrating’ dermatofibroma and dermatofibrosarcoma protuberans. Semin Cutan Med Surg 18:91–98
Swan MC, Banwell PE, Hollowood K, Goodacre TE (2005) Late recurrence of dermatofibrosarcoma protuberans in the female breast: a case report. Br J Plast Surg 58(1):84–87
Chang CK, Jacobs IA, Saltic GI (2004) Outcomes of surgery for dermatofibrosarcoma protuberans. EJSO 30:341–345
Sei JF, Tchakerian A, Zimmermann U, et al (2004) Treatment of dermatofibroma protuberans with fixed Moh’s micrographic surgery. Ann Dermatol Venereol 131(2):158–160
Haas RL, Keus RB, Loftus BM, et al (1997) The role of radiotherapy in the local management of dermatofibrosarcoma protuberans. Soft tissue tumors working group. Eur J Cancer 33: 1055–1060
Ballo MT, Zagars GK, Pisters P, et al (1998) The role of radiation therapy in the management of dermatofibrosarcoma protuberans. Int J Radiat Oncol Biol Phys 40:823–827