10.5826/dpc.1203a97
text/xml
2160-9381
2015
en
Keshavamurthy  Vinay
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
A solitary nodule over the chest
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-07-28
2021-09-06
2022-07-28
2022-09-13
e2022097
Dermatol Pract Concept
Keshavamurthy  Vinay
2022/07/28
10.5826/dpc.1203a97
e2022097
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research; Chandigarh, India
2160-9381
en
e2022097
Allen A, Ahn C, Sangueza OP. Dermatofibrosarcoma Protuberans. Dermatol Clin. 2019;37(4):483-488. DOI: 10.1016/j. det.2019.05.006. PMID: 31466588.
A solitary nodule over the chest
https://dpcj.org/index.php/dpc/article/download/2015/1692
                         A Solitary Nodule Over the Chest
                         Gitesh Sawatkar1, Nisha Meshram2, Keshavamurthy Vinay3


1 Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS), Nagpur, India
2 Department of Pathology, All India Institute of Medical Sciences (AIIMS), Nagpur, India
3 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research; Chandigarh, India



Citation: Sawatkar G, Meshram N, Vinay K. A solitary nodule over the chest. Dermatol Pract Concept. 2022;12(3):e202297.
DOI: https://doi.org/10.5826/dpc.1203a97
Accepted: October 26, 2021; Published: July 2022
Copyright: ©2022 Sawatkar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication
Corresponding author: Dr. Keshavamurthy Vinay, Department of Dermatology, Venereology and Leprology Postgraduate Institute of
Medical Education and Research, Sector 12, Chandigarh 160012, India. Tel: +91-8872993222 E-mail: vinay.keshavmurthy@gmail.com




Case Presentation                                                       Teaching Point
A 35-year-old male presented with an asymptomatic,                      Dermatofibrosarcoma protuberans presents as an asymp-
subcutaneous mass with an overlying firm, red-brown
­                                                                       tomatic, slowly progressive indurated plaque that subse-
­nodule and shiny stretched skin (Figure 1A). On d
                                                 ­ ermoscopy,           quently develops nodules. Dermoscopic features suggestive
an ­
   accentuated pigment network over background of                       of DFSP are: delicate pigment network, vessels, structureless
pinkish color was seen. A few structureless focal white ar-             light brown areas, shiny white streaks, pink background col-
eas were present (Figure 1B). Histopathology revealed a                 oration, and structureless hypo- or depigmented areas [1].
poorly ­circumscribed dermal tumor with a clear grenz zone.                  Mohs micrographic surgery remains the treatment of
The ­
    tumor consisted of monomorphic spindle cells with                   choice. Imatinib and sorafenib can be employed for unre-
­elongated hyperchromatic nuclei arranged in fascicles form-            sectable and metastatic DFSP [2]. This report reinstitutes the
ing a storiform pattern (Figure 1C). Clinical, dermoscopic              importance of keen clinical and dermoscopic examination
and histopathological features confirmed the diagnosis of               with histopathological correlation for timely diagnosis of
dermatofibrosarcoma protuberans (DFSP).                                 this dermal tumor.




Image Letter | Dermatol Pract Concept. 2022;12(3):e202297                                                                             1
Figure 1. (A) Red-brown nodule with overlying shiny stretched skin present over right side of chest. (B) Dermatoscopy (DermLite™
DL3 - 3Gen under contact polarized mode) showing pinkish red b  ­ ackground and unfocussed vessels (yellow arrow), accentuated pigment
­network (green arrowhead) and focal white areas (black arrow head). (C) Sections shows epidermis with grenz zone and underlying
 ­dermal tumor in storiform pattern. Entrapped adnexal structure and adipose tissue seen (H&E, 4x).



References                                                            2. Allen A, Ahn C, Sangueza OP. Dermatofibrosarcoma Protu-
                                                                         berans. Dermatol Clin. 2019;37(4):483-488. DOI: 10.1016/j.
1. Bernard J, Poulalhon N, Argenziano G, Debarbieux S, Dalle S,          det.2019.05.006. PMID: 31466588.
   Thomas L. Dermoscopy of dermatofibrosarcoma protuberans:
   a study of 15 cases. Br J Dermatol. 2013;169(1):85-90. DOI:
   10.1111/bjd.12318. PMID: 23496114.




2                                                                            Image Letter | Dermatol Pract Concept. 2022;12(3):e202297
