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Dermatofibroma, Dermatofibrosarcoma Protuberans, Mohs Micrographic Surgery
A 41-year-old African American male complains of a painful cyst located on his right shoulder and lasting 2 years. The specimen was excised and stained positive for CD34 and negative for SOX-10, confirming the diagnosis of Dermatofibrosarcoma Protuberans (DFSP). The initial specimen had positive extension at both the deep and lateral margins. Complete removal of the tumor required 3 stages of MMS resulting in a 10 cm x 7.6 cm final defect, extending to muscle. As demonstrated in this case, DFSP has an erratic growth pattern and requires meticulous histopathological examination to ensure clear margins. MMS is the preferred method of treatment. Cases of DFSP have high rates of recurrence and require regular follow-up for 3-5 years after treatment.
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