Figure 3: Healed excision site with minimal scar post treatment
DISCUSSION
DFSP is a recurrent, locally invasive tumor arising mostly from the
dermis and subcutaneous fat. Patients mostly present with slow growing
multinodular growth in trunk.1 It’s predominantly seen
in 20-40 years of age, in which skin coloured indurated, multinodular
solitary plaque is seen over trunk, shoulder and pelvic areas. There’s
no gender predilection of the disease.6 Recurrence is
a common rule in DFSP and most of the tumors exhibit recurrence that
warrant wide excision with margin.Even after years of treatment,
patients can present with lesions suggestive of the disease that need
surgery along with reconstruction flaps.7 These tumors
have locally invasive potential and need recurrent surveillance and
follow up visits along with proper counselling.8 As
DFSP is rare, given the limitation of available diagnostic modalities
like Immunohistochemistry (IHC), in a resource- poor setting, diagnosis
can be confusing. Diagnosis can be made with good clinical acumen,
histopathology and IHC. With proper diagnosis, overall prevalence of the
disease can be estimated and clinical therapeutic trials can be
performed with timely prevention of fibrosarcomatous transformation in
those with potential. DFSP has the potential for recurrence and local
invasion of tissues nearby.9