Satya adds, “For the last 2 years on the left side of the chest, I could see a red patch which was increasing in size. The touch and feel of the same was rubbery. It had a different texture than my usual skin. Initially I ignored it thinking that It might be an insect bite or some mole, but as it started to grow and show changes, I decided to consult a specialist. The growth was exponential in the last 6 months.”
His initial surgery was done outside, the biopsy revealed Dermatofibroma, which is a benign (Non-Cancerous) condition. But on review of the same specimen (Block) and further testing (IHC-Immunohistochemistry) revealed it to be Dermatofibrosarcoma, which is a cancerous disease with a tendency to recur locally. It is a rare cancer that is characterized with tentacle like growth. Dermatofibrosarcoma Protuberans (DFSP) is most commonly found on the abdomen & chest, but can also be seen on the arms, legs, head and neck. It has a tendency to recur in the same location after it is removed. However, it spreads to other parts of the body in about 5% of cases.
According to Dr. R N Mittal, Sr Consultant Surgical Oncology, Paras Hospitals, Gurgaon, “Satya’s case is indeed unique. The biopsy and tests revealed that even after the initial surgery he had a residual cancerous tumor in his upper chest. A soft tissue cancer approx. 5*4 cm with thickening & discoloration of overlying skin. The contrast CT scan of chest also confirmed the clinical findings. The tumor was affecting the overlying skin and was abutting (touching) the underlying pectoralis major muscle. This muscle creates the bulk in the chest wall.”
“It was decided that an immediate surgery be performed to excise and limit the cancer. The surgery included the removal of the tumor with wide margin, along with the excision of the overlying skin and underlying muscle. Final biopsy report revealed the closest margin 3.5 cm from the tumor so this patient now will not require any radiotherapy. Such a tumor has to be closely monitored as it has the tendency of reoccurring. DFSP tends to affect people between the age of 20 and 50, but it has been diagnosed in people of all ages. There are about 1,000 cases diagnosed in the United States each year, with an incidence of about 1-5 people per million. The tumors affect black patients about twice as much as white patients,” adds Dr. Mittal.
Signs and Symptoms of Dermatofibrosarcoma:
- Abnormal growth on the skin that doesn’t go away
- Change in the skin pattern of a scar or a burn
- Change in the skin structure, color and pattern
Treatment of Dermatofibrosarcoma:
- For Dermatofibrosarcoma, surgery with wide excision is the treatment of choice
- For tumors with positive margins, it should be re-excised
- For tumors with close margin, re-surgery or radiotherapy can be considered
- In locally advance & metastatic tumors, there is a role of Imatinib (under trial)
Risk factors and causes of Dermatofibrosarcoma:
- Dark skinned people are at higher risk
- Pregnant women may have fast growing tumors
- It can also be due to mutation of the genetic material
- Dermatofibrosarcoma is not believed to be a hereditary condition
