School of Podiatric Medicine - Student Research
Document Type
Article
Publication Date
Spring 2026
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a rare, slow‑growing soft‑tissue sarcoma that may appear clinically benign, particularly in the foot and ankle. Within the literature published, DFSP is suggested to carry a comparatively worse prognosis in the lower extremity. This article describes a 59‑year‑old Hispanic male who presented with a longstanding dorsolateral left‑foot mass and extensive comorbidities, including type 2 diabetes mellitus, coronary artery disease status post‑CABG, heart failure with reduced ejection fraction, atrial fibrillation, diabetic neuropathy, and chronic medication nonadherence.
Although the mass was present for more than a decade with minimal subjective growth, recent enlargement and superimposed infection prompted further evaluation. The MRI demonstrated a 3.3 × 3.3 × 2.4 cm enhancing soft‑tissue mass with features concerning for neoplasm. Given the patient’s limited healing potential and complex medical status, an interdisciplinary team involving podiatry, oncology, cardiology, vascular medicine, and endocrinology coordinated diagnostic and perioperative planning.
Initial biopsy revealed a spindle‑cell proliferation in a storiform pattern. Immunohistochemistry showed strong CD34 positivity, and fluorescence in situ hybridization confirmed PDGFB rearrangement (22q13), establishing the diagnosis of DFSP. One of the current effective treatments is a complete excision with 2–3 cm margins, followed by long‑term surveillance due to the high recurrence nature and infiltration of this tumor. The patient subsequently underwent excisional biopsy with wide margins. Gross pathology demonstrated a tan, irregular soft‑tissue mass measuring 7.5 × 5.6 × 1.5 cm, with the tumor growth extending within 5 mm of the closest lateral and deep margins: a narrow negative margin. This case emphasizes the importance of pursuing biopsy when imaging is inconclusive, utilizing interdisciplinary coordination to safely manage oncologic pathology in medically complex patients, and realizing when patients need adjuvant radiation therapy. Relevant literature on DFSP epidemiology, etiology, prognosis, evidence‑based treatment guidelines or alternatives, and long‑term surveillance considerations are also reviewed in this article.
Recommended Citation
Anjorin, Christopher I. and Bender, Joseph DPM, "What in the DFSP? A Case-Study and Literature Review of Dermatofibrosarcoma Protuberans in the Lower Extremity" (2026). School of Podiatric Medicine - Student Research. 32.
https://scholarworks.utrgv.edu/sopm_mspub/32
