Dermatofibrosarcoma protuberans: review of 20-years experience.

INTRODUCTION: Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue neoplasm with low-intermediate grade of malignancy. It is a locally aggressive tumour with a high recurrence rate. Surgical excision with adequate margins is the main treatment. MATERIALS AND METHODS: We describe the clinicopathological features of 21 cases of DFSP. The mean size of the lesions was 5.6 cm, mostly located in trunk. 61.9% of the cases underwent surgical excision without previous biopsy. 52.4% of the patients presented positive margins, that required surgical extension. RESULTS: The recurrence rate was 28.6% (6 cases), five of them local recurrences treated with new surgical excision with wide margins. Median period free of illness was 32.5 months. Medium follow-up period was 33.25 months. CONCLUSIONS: DFSP has a locally high recurrence rate, that has been associated to inadequate surgical margins. The histological knowledge preoperatively would permit surgical excision with adequate margins, and probably this could reduce the recurrence rate. Radiotherapy could avoid the surgical extension of margins in these cases with positive ones. Chemotherapy could be indicated in metastasic cases. Most recurrences appear in the first 3 years, but it is important a long-term follow-up of these patients.

[Mammary hamartoma]. / Hamartoma mamario.

For many years, mammary hamartoma was considered to be an under-diagnosed disease. However, with the increasing use of diagnostic procedures in breast tumors (mammography, ultrasound, fine needle aspiration cytology and core needle biopsy), diagnosis of this entity has increased. Mammary hamartomas normally manifest as painless, mobile, palpable lumps without adherence to skin or muscle. Mammography shows well-circumscribed tumors, separated from adjacent normal breast tissue. Macroscopically they are well-defined tumors, consisting of benign mammary glandular tissue, fibrous stroma and fat in variable proportions, sometimes with a pseudoencapulation. Because of the lack of cytological and architectural specificity of hamartomas, correlation between clinical manifestations, imaging techniques and histology is essential. This report describes a case of an 11-cm mammary hamartoma in a 46-year-old woman.

Hamartoma mamario / Mammary hamartoma

El hamartoma mamario se ha considerado durante mucho tiempo como una enfermedad infradiagnosticada, pero con el aumento progresivo en la utilización de procedimientos diagnósticos en las tumoraciones mamarias (mamografía, ecografía, punción aspiración con aguja fina y biopsia con aguja gruesa) el número de casos diagnosticados ha aumentado. Los hamartomas mamarios suelen manifestarse como masas indoloras, móviles y no adheridas a piel ni a músculo. En la mamografía se suelen observar tumoraciones bien delimitadas, separadas del tejido mamario normal. Macroscópicamente son tumores bien definidos, compuestos de tejido glandular mamario de características benignas, estroma fibrosa y tejido graso en cantidades variables, en ocasiones seudoencapsulados. La correlación de las manifestaciones clínicas y las pruebas de imagen con la histología es completamente necesaria, debido a la falta de especificidad citológica y arquitectural de los hamartomas. Este artículo describe un caso de hamartoma mamario de 11 cm de diámetro en una mujer de 46 años de edad (AU)

For many years, mammary hamartoma was considered to be an under-diagnosed disease. However, with the increasing use of diagnostic procedures in breast tumors (mammography, ultrasound, fine needle aspiration cytology and core needle biopsy), diagnosis of this entity has increased. Mammary hamartomas normally manifest as painless, mobile, palpable lumps without adherence to skin or muscle. Mammography shows well-circumscribed tumors, separated from adjacent normal breast tissue. Macroscopically they are well-defined tumors, consisting of benign mammary glandular tissue, fibrous stroma and fat in variable proportions, sometimes with a pseudoencapulation. Because of the lack of cytological and architectural specificity of hamartomas, correlation between clinical manifestations, imaging techniques and histology is essential. This report describes a case of an 11-cm mammary hamartoma in a 46-year-old woman (AU)

Dermatofibrosarcoma protuberans: review of 20-years experience

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Introduction. Dermatofibrosarcoma protuberans(DFSP) is an uncommon soft tissue neoplasm withlow-intermediate grade of malignancy. It is a locallyaggressive tumour with a high recurrence rate. Surgicalexcision with adequate margins is the maintreatment.Materials and methods. We describe the clinicopathologicalfeatures of 21 cases of DFSP. Themean size of the lesions was 5.6 cm, mostly locatedin trunk. 61.9% of the cases underwent sugical excisionwithout previous biopsy. 52.4% of the patientspresented positive margins, that required surgicalextension.Results. The recurrence rate was 28.6% (6 cases),five of them local recurrences treated with new surgicalexcision with wide margins. Median periodfree of illness was 32.5 months. Medium follow-upperiod was 33.25 months.Conclusions. DFSP has a locally high recurrencerate, that has been associated to inadequate surgicalmargins. The histological knowledge preoperativelywould permit surgical excision with adequatemargins, and probably this could reduce the recurrencerate. Radiotherapy could avoid the surgicalextension of margins in these cases with positiveones. Chemotherapy could be indicated in metastasiccases. Most recurrences appear in the first 3years, but it is important a long-term follow-up ofthese patients

Biopsia selectiva del ganglio centinela en el melanoma / Selective sentinel node biopsy in melanoma

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