Abstract

A 78-year-old-man with a 10-year history of subcutaneous tumor on his upper back, visited our clinic in October 1996. The tumor had been excised three times, and the patient had received chemotherapy and radiation therapy before, but the tumor had recurred. The patient had a 5.5×6.0cm, poorly demarcated tumor and enlargement of anterior mediastinal lymph node was observed by computer tomography examination. A biopsy specimen revealed a dense proliferation of atypical spindle cells arranged in a storiform or herring-bone pattern extending into the subcutis. The operation specimens excised previously were also examined. The tumors were composed of spindle cells and/or histiocytelike cells, and the grade of the nuclear atypia became higher at each time of the recurrence. Immunohistochemical staining for CD34 was negative in the previous specimens but positive in the last one. A diagnosis of dermatofibrosarcoma protuberans was done and the tumor was extensively excised in November 1996. The patient had multiple metastases and died in April 1997.