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Dermatofibrosarcoma protuberans in Adult
Other Resources UpToDate PubMed

Dermatofibrosarcoma protuberans in Adult

Contributors: Christine S. Ahn MD, FAAD, William W. Huang MD, MPH, FAAD, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed


Dermatofibrosarcoma protuberans (DFSP) is a fibroblast-derived intermediate-grade soft tissue sarcoma. It is usually observed in young to middle-aged adults, although it can occur in children as either a congenital or acquired lesion. DFSP is almost twice as common in individuals of African descent and has a slight female predominance. Up to 90% of DFSPs harbor a translocation t(17;22) resulting in a fusion of collagen 1a1 (COLL1A1) and platelet-derived growth factor B (PDGFB) genes, leading to constitutively activated tyrosine kinase signaling.

DFSP typically presents as a slow-growing, red-brown, indurated plaque with irregular nodularity in an adult. The most common site is the trunk, followed by the proximal extremities, head, and neck. In children, DFSP can appear atrophic, hypopigmented, or blue-red in color.

DFSP is an uncommon neoplasm with low metastatic potential, carrying a 2%-5% risk of distant metastasis. However, it can be locally aggressive and has a high rate of recurrence after surgical excision. Poor prognostic factors include older age, male sex, and larger tumor size. Approximately 9%-20% of tumors can undergo fibrosarcomatous degeneration.

Related topic: giant cell fibroblastoma


C44.99 – Other specified malignant neoplasm of skin, unspecified

276799004 – Dermatofibrosarcoma protuberans

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Differential Diagnosis & Pitfalls

  • Keloid
  • Hypertrophic scar (see Scar)
  • Dermatofibroma
  • Dermatomyofibroma
  • Melanoma
  • Non-AIDS Kaposi sarcoma
  • Rheumatoid nodule
  • Cutaneous squamous cell carcinoma
  • Pseudolymphoma
  • Morphea
  • Metastatic cutaneous carcinoma
  • Solitary neurofibroma
  • Cutaneous leiomyoma
  • Desmoid tumor
  • Fibrosarcoma
  • Nodular fasciitis
  • Sarcoidosis
  • Keloidal histoid leprosy (see Leprosy)

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Last Reviewed:06/13/2018
Last Updated:02/21/2023
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Dermatofibrosarcoma protuberans in Adult
A medical illustration showing key findings of Dermatofibrosarcoma protuberans : Shoulder, Smooth nodule, Smooth plaque, Trunk, Upper arm
Clinical image of Dermatofibrosarcoma protuberans - imageId=905284. Click to open in gallery.  caption: 'A close-up of a bosselated, white, pink, and brown plaque and an adjacent surgical scar.'
A close-up of a bosselated, white, pink, and brown plaque and an adjacent surgical scar.
Copyright © 2024 VisualDx®. All rights reserved.