Anterior chest wall Dermatofibrosarcoma protuberans extension to the anterior mediastinum: Case report

Abstract

Introduction

Dermatofibrosarcoma protuberans (DFSP) is a tumor of the subcutaneous tissue that grows slowly and invades locally, rarely spreading to other parts of the body but often recurring after surgery.

Case presentation

This case report presents a 59-year-old man with a recurrent, large Dermatofibrosarcoma Protuberans (DFSP) tumor. The tumor had grown significantly, extending from the anterior chest wall into the mediastinum through the foramen of Morgagni and into the left chest cavity, directly invading the left anterior chest wall. The mass was surgically removed, and the resulting chest wall defect was repaired using a latissimus dorsi muscle flap and a split-thickness skin graft. The patient was successfully discharged 10 days after surgery, following the healing of the wound and skin graft.

Clinical discussion

DFSPs represent less than 1 percent of all soft tissue tumors. Over 90 % of DFSP tumors have the chromosomal translocation t(17;22). Typically, Mohs micrographic surgery with continuous histological margin control is needed to reduce local recurrence rates. Adjuvant chemotherapy and radiation therapy may be useful.

Conclusion

Surgical approaches such as Mohs micrographic surgery or wide local excision with 5 cm negative margins are essential to prevent recurrence and minimize the overall impact of the disease. Mohs micrographic surgery is a specialized technique that aims for complete tumor removal while preserving as much healthy tissue as possible.