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