Wide Local Excision for Dermatofibrosarcoma Protuberans: A Surgical Approach

Introduction: Darier and Ferrand dermatofibrosarcoma is a locally malignant soft-tissue sarcoma with a high recurrence rate and rare metastasis, first described in 1924. Results: This retrospective study analyzes 20 cases of chest wall dermatofibrosarcoma treated at Hassan II University Hospital in Fez from 2009 to 2023. The median patient age was 44.95 years, with a slight female predominance. Tumors varied in size and presentation, commonly appearing as multi-nodular or ulcerating masses. Histological analysis showed spindle-shaped cells with CD34 expression. Surgical treatment involved wide excision with a 5 cm safety margin, followed by reconstruction using skin grafting or directed healing. Conclusion: Over an average follow-up of 23 months, no recurrences were observed, highlighting the importance of early diagnosis and multidisciplinary management to improve outcomes and minimize the need for complex surgical repairs.