A Case of Recurrent Dermatofibrosarcoma Protuberans With Fibrosarcomatous Transformation

Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma with a generally low risk for metastasis. Most individuals are diagnosed with this neoplasm in the third or fourth decade of life, with the growth usually being no larger than 5 cm in maximum diameter at the time of diagnosis. The majority of these patients are treated with wide local excision, with most experiencing no recurrence or metastasis. There are, however, cases of DFSP that are characterized by the presence of a high-grade fibrosarcomatous component, which represents a more ominous finding and exhibits a far more troubling course. To underscore the difference in the two presentations, we report a case of DFSP with fibrosarcomatous transformation in a 45-year-old man with two previous excisions. The size of the lesion, along with other characteristic findings, has been shown to worsen prognosis and increase risk of metastasis. Therefore, further research into the condition and therapeutic modalities to help patients is warranted.