Tissue Damage in a Patient with Neglected Dermatofibrosarcoma Protuberans (DFSP) at Pakan Kamis Community Health Center: A Rare Case Report

Background: Dermatofibrosarcoma protuberans is a rare soft-tissue sarcoma. Diagnostic delays in primary care often lead to extensive tissue damage. This report illustrated the clinical course and management challenges of a neglected tumor at a community health center. Case Presentation: A 50-year-old laundry worker presented in February 2024 with a 3-year history of right upper back pain and a violaceous, firm nodule (3 × 2 × 1 cm) previously treated by traditional healers. Radiographs excluded bone involvement. Excisional biopsy confirmed DFSP with fibrosarcomatous features. In April 2024, wide excision with 2 cm margins achieved clear histologic borders. From May 2024 to January 2025, she received adjuvant radiotherapy (35 × 2 Gy), during which skin blistering and infection were managed with bi-daily wound care. A surveillance CT in January 2025 showed stable necrotic changes and no metastases. Persistent shoulder pain and restricted mobility prompted physiotherapy. Discussion: Dermatofibrosarcoma protuberans (DFSP) is a rare, indolent sarcoma whose delayed recognition in primary care—as illustrated here—necessitated wide excision and radiotherapy, underscoring the value of early diagnosis and a coordinated, multidisciplinary treatment strategy. Post‐treatment physiotherapy targeting shoulder pain was essential to restore function, improve mobility, relieve pain, and optimize the patient’s quality of life. Conclusion: Early recognition of atypical cutaneous lesions, structured referral pathways, and a multidisciplinary approach are essential in resource-limited settings. Enhanced training for general practitioners and integration of surgical, oncologic, radiotherapeutic, and rehabilitative services can reduce diagnostic delays and optimize functional recovery. Keywords: Neglected Cancer, Sarcoma, Dermatofibrosarcoma Protuberans (DFSP), Tissue Damage