What is the role of imaging studies in the diagnosis of dermatofibrosarcoma protuberans (DFSP)?

Updated: Mar 06, 2020
  • Author: Raman K Madan, MD; Chief Editor: William D James, MD  more...
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In most cases of dermatofibrosarcoma protuberans (DFSP), no imaging studies are used unless metastatic disease is suspected after a thorough history taking and a complete physical examination. Note the following:

Dermoscopy is still evolving. A small study looking at 15 cases of DFSP found the median number of dermoscopic features was four per lesion. In the study, the following dermoscopic features were noted: delicate pigmented network (87%), vessels (80%), structureless light-brown areas (73%), shiny white streaks (67%), pink background coloration (67%), and structureless hypopigmented or depigmented areas (60%). When detected, vessels were of the arborizing type in 11 of 12 cases and presented as either unfocused only or both unfocused and focused. Further studies are still required to determine whether dermoscopy can help to identify suspected DFSP. [20]

Chest radiography may be ordered for baseline screening for pulmonary metastasis in high-risk cases, such as recurrence or suspicion for a fibrosarcoma variant of DFSP. [14]

Computed tomography scanning is indicated if direct bone involvement or metastasis is suspected. [1]

Studies support a role of magnetic resonance imaging (MRI) for preoperative assessment in larger or atypical lesions and recurrent disease. With its high soft tissue resolution and contrast, MRI may be helpful for defining the approximate tumor border and depth of invasion. [14, 21, 22, 23]

Ultrasonography may be helpful for monitoring local DFSP or regional lymph node metastasis.

Reports suggest fluorodeoxyglucose (FDG)–positron emission tomography scanning may be helpful in monitoring metastatic disease. [16, 24]

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