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Case Reports in Dermatological Medicine
Volume 2016, Article ID 6074182, 5 pages
http://dx.doi.org/10.1155/2016/6074182
Case Report

Nodular Fasciitis Complicating a Staged Surgical Excision of Dermatofibrosarcoma Protuberans

1Department of Dermatology, The University of Texas Medical Branch, Galveston, TX 77555, USA
2Department of Otolaryngology, The University of Texas Medical Branch, Galveston, TX 77555, USA

Received 11 August 2016; Accepted 10 November 2016

Academic Editor: Kowichi Jimbow

Copyright © 2016 C. Helen Malone et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Dermatofibrosarcoma protuberans (DFSP) is an unusual spindle cell tumor with a high rate of local recurrence with traditional excision. Fortunately, Mohs micrographic surgery yields excellent cure rates for this neoplasm due to contiguous tumor spread and meticulous tumor mapping and margin analysis. We present the unique case of a patient treated with a modified Mohs technique with an analysis of the final margin with permanent sections, who developed a spindle cell neoplasm in the margins of her second stage excision consistent with nodular fasciitis. Distinguishing residual DFSP from a benign reactive process was an essential and challenging component of this patient’s management.