Dermatofibrosarcoma protuberans: 35 patients treated with Mohs micrographic surgery using paraffin sections

Summary Background Dermatofibrosarcoma protuberans (DFSP) has conventionally been treated with wide local excision. More recently Mohs micrographic surgery (MMS) has been advocated. Objectives To assess our departmental experience with DFSP in the context of a literature review relating to DFSP treated with MMS. Methods This was a case review of 35 patients with DFSP treated between 1998 and 2009 with MMS using paraffin-embedded sections. Results Seventeen patients required one horizontal layer to clear their tumour, 10 patients needed two and eight patients needed three layers or more. The median preoperative clinical size was 6 cm2 (range 0·75–54·8) and the median postoperative wound size was 46·8 cm2 (range 4–145·2). Tumour persistence has not been observed in any of our patients after a median follow-up duration of 29·5 months (range 6–146). Conclusions We present 35 DFSP patients, none of whom showed persistent tumour after treatment with ‘slow’ MMS using paraffin sections. We advocate MMS as the treatment of choice for DFSP, especially for tumours over the head and neck region where tissue conservation is particularly important.