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Dermatofibrosarcoma protuberans(DFSP)

MedGen UID:
811326
Concept ID:
C3693482
Neoplastic Process
Synonyms: DERMATOFIBROSARCOMA PROTUBERANS, SOMATIC; DFSP; Familial dermatofibrosarcoma protuberans (subtype); GIANT CELL FIBROBLASTOMA; Metastatic dermatofibrosarcoma protuberans (subtype)
SNOMED CT: Giant cell fibroblastoma of skin (238863004); Giant cell fibroblastoma (128742004); Giant cell fibroblastoma (238863004)
Modes of inheritance:
Not genetically inherited
MedGen UID:
988794
Concept ID:
CN307044
Finding
Source: Orphanet
clinical entity without genetic inheritance.
 
Monarch Initiative: MONDO:0011934
OMIM®: 607907
Orphanet: ORPHA31112

Definition

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, locally aggressive, but rarely metastasizing tumor of the deep dermis and subcutaneous tissue. It typically presents during early or middle adult life and is most frequently located on the trunk and proximal extremities (Sandberg et al., 2003). [from OMIM]

Additional description

From MedlinePlus Genetics
Dermatofibrosarcoma protuberans is a rare type of cancer that causes a tumor in the deep layers of skin. This condition is a type of soft tissue sarcoma, which are cancers that affect skin, fat, muscle, and similar tissues.

In dermatofibrosarcoma protuberans, the tumor most often starts as a small, firm patch of skin, usually 1 to 5 centimeters in diameter, that is usually purplish, reddish, or flesh-colored. The tumor typically grows slowly and can become a raised nodule. Occasionally, the tumor begins as a flat or depressed patch of skin (plaque). Tumors are most commonly found on the torso and can also be found on the arms, legs, head, or neck. Affected individuals usually first show signs of this condition in their thirties, but the age at which a tumor appears varies widely.

In dermatofibrosarcoma protuberans, the tumor has a tendency to return after being removed. However, it does not often spread to other parts of the body (metastasize).

There are several variants of dermatofibrosarcoma protuberans in which different cell types are involved in the tumor. Bednar tumors, often called pigmented dermatofibrosarcoma protuberans, contain dark-colored (pigmented) cells called melanin-containing dendritic cells. Myxoid dermatofibrosarcoma protuberans tumors contain an abnormal type of connective tissue known as myxoid stroma. Giant cell fibroblastoma, which is sometimes referred to as juvenile dermatofibrosarcoma protuberans because it typically affects children and adolescents, is characterized by giant cells in the tumor.

Rarely, the tumors involved in the different types of dermatofibrosarcoma protuberans can have regions that look similar to fibrosarcoma, a more aggressive type of soft tissue sarcoma. In these cases, the condition is called fibrosarcomatous dermatofibrosarcoma protuberans or FS-DFSP. FS-DFSP tumors are more likely to metastasize than tumors in the other types of dermatofibrosarcoma protuberans.  https://medlineplus.gov/genetics/condition/dermatofibrosarcoma-protuberans

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDermatofibrosarcoma protuberans

Professional guidelines

PubMed

Shah A, Tassavor M, Sharma S, Torbeck R
Dermatol Online J 2021 Jun 15;27(6) doi: 10.5070/D327654070. PMID: 34387070
Miller SJ, Alam M, Andersen JS, Berg D, Bichakjian CK, Bowen GM, Cheney RT, Glass LF, Grekin RC, Ho AL, Kessinger A, Liegeois N, Lydiatt DD, Michalski J, Morrison WH, Nehal KS, Nelson KC, Nghiem P, Olencki T, Perlis CS, Shaha AR, Tuli M, Urist MM, Wang LC, Zic JA; National Comprehensive Cancer Network
J Natl Compr Canc Netw 2012 Mar;10(3):312-8. doi: 10.6004/jnccn.2012.0032. PMID: 22393193
Miller SJ, Alam M, Andersen J, Berg D, Bichakjian CK, Bowen G, Cheney RT, Glass F, Grekin RC, Grichnik JM, Kessinger A, Lee NY, Lessin S, Lydiatt DD, Margolis LW, Michalski J, Nehal KS, Nghiem P, Oseroff AR, Rosenberg EW, Shaha AR, Siegle RJ, Urist MM; National Comprehensive Cancer Network
J Natl Compr Canc Netw 2007 May;5(5):550-5. doi: 10.6004/jnccn.2007.0048. PMID: 17509257

Curated

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Soft Tissue Sarcoma, 2024

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Dermatofibrosarcoma Protuberans, 2022

Recent clinical studies

Etiology

Walocko F, Christensen RE, Worley B, Alam M
Dermatol Clin 2023 Jan;41(1):133-140. Epub 2022 Oct 28 doi: 10.1016/j.det.2022.07.011. PMID: 36410974
Tillman BN, Liu JC
Otolaryngol Clin North Am 2021 Apr;54(2):369-378. Epub 2021 Feb 16 doi: 10.1016/j.otc.2020.11.010. PMID: 33602520
Allen A, Ahn C, Sangüeza OP
Dermatol Clin 2019 Oct;37(4):483-488. doi: 10.1016/j.det.2019.05.006. PMID: 31466588
Reha J, Katz SC
Surg Clin North Am 2016 Oct;96(5):1031-46. doi: 10.1016/j.suc.2016.05.006. PMID: 27542641
Mendenhall WM, Zlotecki RA, Scarborough MT
Cancer 2004 Dec 1;101(11):2503-8. doi: 10.1002/cncr.20678. PMID: 15503305

Diagnosis

Vitiello GA, Lee AY, Berman RS
Surg Clin North Am 2022 Aug;102(4):657-665. doi: 10.1016/j.suc.2022.05.004. PMID: 35952694
Tillman BN, Liu JC
Otolaryngol Clin North Am 2021 Apr;54(2):369-378. Epub 2021 Feb 16 doi: 10.1016/j.otc.2020.11.010. PMID: 33602520
Bhatt MD, Nambudiri VE
Hematol Oncol Clin North Am 2019 Feb;33(1):87-101. doi: 10.1016/j.hoc.2018.08.007. PMID: 30497679
Reha J, Katz SC
Surg Clin North Am 2016 Oct;96(5):1031-46. doi: 10.1016/j.suc.2016.05.006. PMID: 27542641
Miller SJ, Alam M, Andersen JS, Berg D, Bichakjian CK, Bowen GM, Cheney RT, Glass LF, Grekin RC, Ho AL, Kessinger A, Liegeois N, Lydiatt DD, Michalski J, Morrison WH, Nehal KS, Nelson KC, Nghiem P, Olencki T, Perlis CS, Shaha AR, Tuli M, Urist MM, Wang LC, Zic JA; National Comprehensive Cancer Network
J Natl Compr Canc Netw 2012 Mar;10(3):312-8. doi: 10.6004/jnccn.2012.0032. PMID: 22393193

Therapy

Shah A, Tassavor M, Sharma S, Torbeck R
Dermatol Online J 2021 Jun 15;27(6) doi: 10.5070/D327654070. PMID: 34387070
Allen A, Ahn C, Sangüeza OP
Dermatol Clin 2019 Oct;37(4):483-488. doi: 10.1016/j.det.2019.05.006. PMID: 31466588
Acosta AE, Vélez CS
Curr Treat Options Oncol 2017 Aug 10;18(9):56. doi: 10.1007/s11864-017-0498-5. PMID: 28795284
Skubitz KM, D'Adamo DR
Mayo Clin Proc 2007 Nov;82(11):1409-32. doi: 10.4065/82.11.1409. PMID: 17976362
Abrams TA, Schuetze SM
Curr Oncol Rep 2006 Jul;8(4):291-6. doi: 10.1007/s11912-006-0035-3. PMID: 17254529

Prognosis

Bhatt MD, Nambudiri VE
Hematol Oncol Clin North Am 2019 Feb;33(1):87-101. doi: 10.1016/j.hoc.2018.08.007. PMID: 30497679
Acosta AE, Vélez CS
Curr Treat Options Oncol 2017 Aug 10;18(9):56. doi: 10.1007/s11864-017-0498-5. PMID: 28795284
Kohlmeyer J, Steimle-Grauer SA, Hein R
J Dtsch Dermatol Ges 2017 Jun;15(6):630-648. doi: 10.1111/ddg.13249. PMID: 28591457
Mendenhall WM, Zlotecki RA, Scarborough MT
Cancer 2004 Dec 1;101(11):2503-8. doi: 10.1002/cncr.20678. PMID: 15503305
Gloster HM Jr
J Am Acad Dermatol 1996 Sep;35(3 Pt 1):355-74; quiz 375-6. doi: 10.1016/s0190-9622(96)90597-6. PMID: 8784271

Clinical prediction guides

Akome J, Ishitsuka Y, Tanemura A, Kubo T, Fujimoto M
Acta Derm Venereol 2024 Sep 24;104:adv41234. doi: 10.2340/actadv.v104.41234. PMID: 39315625Free PMC Article
Reilly DJ, Loo YL, Alexander WM, Wilks DJ, MacGregor D, Coombs CJ
Ann Plast Surg 2022 Mar 1;88(3):319-322. doi: 10.1097/SAP.0000000000002970. PMID: 34387577
Tariq MU, Din NU, Abdul-Ghafar J, Park YK
Diagn Pathol 2021 Apr 20;16(1):32. doi: 10.1186/s13000-021-01095-2. PMID: 33879215Free PMC Article
Dachy G, Fraitag S, Boulouadnine B, Cordi S, Demoulin JB
J Cell Mol Med 2021 May;25(9):4387-4394. Epub 2021 Apr 8 doi: 10.1111/jcmm.16502. PMID: 33830670Free PMC Article
Basu S, Goliwale F
J Nucl Med Technol 2016 Jun;44(2):88-9. Epub 2015 Sep 3 doi: 10.2967/jnmt.115.163212. PMID: 26338485

Recent systematic reviews

Kuhlmann C, Ehrl D, Taha S, Wachtel N, Schmid A, Bronsert P, Zeller J, Giunta RE, Eisenhardt SU, Braig D
Surgery 2023 Jun;173(6):1463-1475. Epub 2023 Apr 1 doi: 10.1016/j.surg.2023.02.026. PMID: 37012145
Henry OS, Platoff R, Cerniglia KS, Batchu S, Goodwin BJ, Sandilos G, Adams A, Hong YK
Am J Surg 2023 Feb;225(2):268-274. Epub 2022 Sep 26 doi: 10.1016/j.amjsurg.2022.09.040. PMID: 36184329
Martin ECS, Vyas KS, Batbold S, Erwin PJ, Brewer JD
Dermatol Surg 2022 May 1;48(5):479-485. Epub 2022 Mar 30 doi: 10.1097/DSS.0000000000003411. PMID: 35353755
Navarrete-Dechent C, Mori S, Barker CA, Dickson MA, Nehal KS
JAMA Dermatol 2019 Mar 1;155(3):361-369. doi: 10.1001/jamadermatol.2018.4940. PMID: 30601909Free PMC Article
Liang CA, Jambusaria-Pahlajani A, Karia PS, Elenitsas R, Zhang PD, Schmults CD
J Am Acad Dermatol 2014 Oct;71(4):781-6. Epub 2014 Apr 19 doi: 10.1016/j.jaad.2014.03.018. PMID: 24755121

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NCCN, 2024
      NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Soft Tissue Sarcoma, 2024
    • NCCN, 2022
      NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Dermatofibrosarcoma Protuberans, 2022

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