Dermatofibrosarcoma protuberans misdiagnosed as keloid and treated with triamcinolone acetonide
INTRODUCTION: Dermatofibrosarcoma protuberans is a rare skin tumor with intermediate malignancy, low metastatic potential, and high recurrence rates after surgical treatment. Owing to a possible clinical resemblance with hypertrophic scars and keloids, the correct diagnosis is fundamental for treatm...
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Thieme Revinter Publicações Ltda.
2016-03-01
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| Series: | Revista Brasileira de Cirurgia Plástica |
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| Online Access: | http://www.rbcp.org.br/export-pdf/1715/en_v31n1a12.pdf |
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| author | Erick Horta Portugal José Carlos Ribeiro Resende Alves Rebeca Paohwa Liu da Fonseca José de Souza Andrade Filho Augusto César de Melo Almeida Izabella Costa Araújo Nárlei Amarante Pereira Raíssa Lemos Ferreira da Silva |
| author_facet | Erick Horta Portugal José Carlos Ribeiro Resende Alves Rebeca Paohwa Liu da Fonseca José de Souza Andrade Filho Augusto César de Melo Almeida Izabella Costa Araújo Nárlei Amarante Pereira Raíssa Lemos Ferreira da Silva |
| author_sort | Erick Horta Portugal |
| collection | DOAJ |
| description | INTRODUCTION: Dermatofibrosarcoma protuberans is a rare skin tumor with intermediate malignancy, low metastatic potential, and high recurrence rates after surgical treatment. Owing to a possible clinical resemblance with hypertrophic scars and keloids, the correct diagnosis is fundamental for treatment success. The objective of the present work is to report on four cases of dermatofibrosarcoma protuberans misdiagnosed as keloid and treated elsewhere with infiltration of triamcinolone acetonide.
METHOD: Between November 1983 and January 2008, four patients with dermatofibrosarcoma protuberans who had undergone intralesional infiltration with triamcinolone acetonide elsewhere were treated because of an erroneous diagnosis of keloid. Radical surgical excision was performed, and 3 cm of healthy tissue was removed from the side margins, including the deep margin, an anatomical structure not infiltrated by the tumor. The patients underwent long-term periodic medical evaluations.
RESULTS: The patients were followed-up for an average of 159 months. Three patients (75%) are still alive without signs of disease at the time of this report. One patient (25%) died of the disease after an attempt to remove the advanced recurrent tumor using extensive craniofacial surgery. Recurrence occurred 7 years after the radical operation.
CONCLUSION: Dermatofibrosarcoma protuberans must be considered in the differential diagnosis of keloids. Intralesional infiltration with triamcinolone acetonide should only be performed after diagnostic confirmation , which may require pathological examination. A careful clinical examination and knowledge of the lesion favor a precise diagnosis and an appropriate treatment. |
| format | Article |
| id | doaj-art-e16aebe2fa734a3eaf6adad1b10ccb4c |
| institution | Matheson Library |
| issn | 1983-5175 2177-1235 |
| language | English |
| publishDate | 2016-03-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Revista Brasileira de Cirurgia Plástica |
| spelling | doaj-art-e16aebe2fa734a3eaf6adad1b10ccb4c2025-08-02T21:36:39ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352016-03-013101828710.5935/2177-1235.2016RBCP0012Dermatofibrosarcoma protuberans misdiagnosed as keloid and treated with triamcinolone acetonideErick Horta Portugal0José Carlos Ribeiro Resende Alves1Rebeca Paohwa Liu da Fonseca2José de Souza Andrade Filho3Augusto César de Melo Almeida4Izabella Costa Araújo5Nárlei Amarante Pereira6Raíssa Lemos Ferreira da Silva7Hospital Felício Rocho, Belo Horizonte, MG, BrazilHospital Felício Rocho, Belo Horizonte, MG, BrazilHospital Felício Rocho, Belo Horizonte, MG, BrazilHospital Felício Rocho, Belo Horizonte, MG, BrazilSociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilSociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilHospital Felício Rocho, Belo Horizonte, MG, BrazilUniversidade Federal de Minas Gerais, Belo Horizonte, MG, BrazilINTRODUCTION: Dermatofibrosarcoma protuberans is a rare skin tumor with intermediate malignancy, low metastatic potential, and high recurrence rates after surgical treatment. Owing to a possible clinical resemblance with hypertrophic scars and keloids, the correct diagnosis is fundamental for treatment success. The objective of the present work is to report on four cases of dermatofibrosarcoma protuberans misdiagnosed as keloid and treated elsewhere with infiltration of triamcinolone acetonide. METHOD: Between November 1983 and January 2008, four patients with dermatofibrosarcoma protuberans who had undergone intralesional infiltration with triamcinolone acetonide elsewhere were treated because of an erroneous diagnosis of keloid. Radical surgical excision was performed, and 3 cm of healthy tissue was removed from the side margins, including the deep margin, an anatomical structure not infiltrated by the tumor. The patients underwent long-term periodic medical evaluations. RESULTS: The patients were followed-up for an average of 159 months. Three patients (75%) are still alive without signs of disease at the time of this report. One patient (25%) died of the disease after an attempt to remove the advanced recurrent tumor using extensive craniofacial surgery. Recurrence occurred 7 years after the radical operation. CONCLUSION: Dermatofibrosarcoma protuberans must be considered in the differential diagnosis of keloids. Intralesional infiltration with triamcinolone acetonide should only be performed after diagnostic confirmation , which may require pathological examination. A careful clinical examination and knowledge of the lesion favor a precise diagnosis and an appropriate treatment.http://www.rbcp.org.br/export-pdf/1715/en_v31n1a12.pdf dermatofibrosarcomakeloidtriamcinolone acetonidediagnostic errors |
| spellingShingle | Erick Horta Portugal José Carlos Ribeiro Resende Alves Rebeca Paohwa Liu da Fonseca José de Souza Andrade Filho Augusto César de Melo Almeida Izabella Costa Araújo Nárlei Amarante Pereira Raíssa Lemos Ferreira da Silva Dermatofibrosarcoma protuberans misdiagnosed as keloid and treated with triamcinolone acetonide Revista Brasileira de Cirurgia Plástica dermatofibrosarcoma keloid triamcinolone acetonide diagnostic errors |
| title | Dermatofibrosarcoma protuberans
misdiagnosed as keloid and treated with
triamcinolone acetonide |
| title_full | Dermatofibrosarcoma protuberans
misdiagnosed as keloid and treated with
triamcinolone acetonide |
| title_fullStr | Dermatofibrosarcoma protuberans
misdiagnosed as keloid and treated with
triamcinolone acetonide |
| title_full_unstemmed | Dermatofibrosarcoma protuberans
misdiagnosed as keloid and treated with
triamcinolone acetonide |
| title_short | Dermatofibrosarcoma protuberans
misdiagnosed as keloid and treated with
triamcinolone acetonide |
| title_sort | dermatofibrosarcoma protuberans misdiagnosed as keloid and treated with triamcinolone acetonide |
| topic | dermatofibrosarcoma keloid triamcinolone acetonide diagnostic errors |
| url | http://www.rbcp.org.br/export-pdf/1715/en_v31n1a12.pdf |
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