Pavillion B 4th FL MC 5338
Redwood City, CA 94063
Facsímil: (650) 320-9443
Yale School Of Medicine, New Haven, CT, 05/18/2015
Yale University Internal Medicine Residency, New Haven, CT, 06/30/2016
Yale University Dept of Dermatology, New Haven, CT, 06/30/2019
Yale University Dept of Dermatology, New Haven, CT, 06/30/2020
Dermatology, American Board of Dermatology
Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous sarcoma, which has been reported in pregnancy. This case series reports the clinical and histopathological findings of DFSP in pregnancy.Eighteen cases of DFSP, including six unreported cases and 12 cases from the literature, were identified. Age, anatomic location, tumor size, changes in tumor characteristics during pregnancy, histopathological features, and treatment were recorded. Follow-up data, when available, were noted.The average age of the cohort was 30.6years (range 19-38). Ten tumors (55.6%) were located on the trunk, four (22.2%) on the head and neck, three (16.7%) on the extremities,and one (5.6%) in the genitalia. Most tumors demonstrated features of conventional DFSP (12/18, 66.7%), while the remaining were identified as DFSP with fibrosarcomatous (FS) change (3/18, 16.7%), atrophic DFSP (2/18, 11.1%), and myxoid DFSP (1/18, 5.6%). Treatment was reported in 17 cases, at least nine of which were treated postpartum. Ten patients were treated with excision, while seven underwent Mohs micrographic surgery. Three patients recurred on follow-up, one with local recurrence and two with distant metastasis.DFSP can undergo enlargement or change in size or color in pregnancy, possibly mediated by hormones. While the majority of cases in this series represented conventional DFSP, unusual clinical and histopathological variants were also present. Treatment in most cases can be safely delayed until after delivery, but recurrent or very large tumors may require treatment prepartum. Close monitoring for recurrence or metastasis is advised.
View details for DOI 10.1111/ijd.15497
View details for Web of Science ID 000636725000001
View details for PubMedID 33818755
View details for DOI 10.1097/DSS.0000000000002852
View details for PubMedID 33481445
View details for DOI 10.1007/s00403-020-02160-4
View details for PubMedID 33175206
View details for DOI 10.1007/s00403-020-02161-3
View details for PubMedID 33155073
View details for DOI 10.1007/s00403-020-02162-2
View details for PubMedID 33150544
Traditionally, second intent healing (SIH) in the periocular region is reserved for small and/or concave defects, particularly those located on the medial canthus.The purpose of this study was to identify factors impacting outcomes of SIH for periocular tumors following Mohs micrographic surgery (MMS).Retrospective analysis was performed of all periocular lesions treated with MMS followed by SIH from a single academic surgical center over a 5-year period. Data regarding tumor characteristics and follow-up was recorded. The modified Manchester scale was utilized to evaluate scar outcomes.Of the 39 tumors included, 14 (35.9%) were located on the lower eyelid, 12 (30.8%) on the upper eyelid, 6 (15.4%) on the lateral canthus, and 7 (17.9%) on the medial canthus. Involvement of the eyelid margin was seen in 11 (28.2%) of cases. The average defect diameter and area were 1.3cm and 1.04cm-squared. Twenty-three cases (59.0%) healed with optimal results. Larger defects were significantly associated with poorer outcomes of SIH (odds ratio 0.205, p=0.017 by multivariate analysis). Anatomic location, involvement of the lid margin, age, and follow-up interval were not significant factors; however, medial canthus defects were least likely to heal with optimal results. On average, medial canthal lesions were larger in size (mean diameter 1.76cm, mean area 1.97cm-squared).This retrospective study suggests that periorbital defects in all locations with area less than 1.04 cm2 heal well by SIH. In this cohort, larger lesions on the medial canthus healed with worse outcomes.
View details for DOI 10.1007/s00403-020-02122-w
View details for PubMedID 32833078
View details for DOI 10.1007/s00403-020-02166-y
View details for PubMedID 33216212
View details for DOI 10.1007/s00403-020-02167-x
View details for PubMedID 33206210