How to recognize cutaneous fibrosarcoma protuberans

Cutaneous fibrosarcoma protuberans is a slow-growing fibrosarcoma that originates in the skin. It is common in middle-aged men and is more likely to occur on the trunk. The damage is a raised dark red mass, which is hard, can be lobulated, and adheres to the skin. Slow growth, generally asymptomatic, easy to relapse if excision is not complete, but rarely metastasize.

The disease is a slow-growing, localized low-grade fibrosarcoma that originates in the skin and can extend into the subcutaneous tissue.

pathophysiology

Macroscopically, the tumor was a limited lobulated hard nodule, and the cut surface was yellowish-brown or off-white. It is located in the skin and rarely invades deep tissues. Within the same tumor, the histological appearance is not the same. However, atypical lesions can usually be found, in which fibroblasts produce reticular fibers, collagen fibers are arranged in a spiral or wheel shape, few mitotic figures, few collagen fibers, rich blood vessels, and occasionally "xanthoma cells" , The dermal papilla is often invaded by tumors, and the epidermis and appendages atrophy. The number of cells and the degree of abnormality vary greatly in different parts of the tumor, and some parts can all be fibrosclerotic. Mitosis is rare. Usually expands around. The relapses are more irregular, with multiple nodules, and have more cellular components than the original ones. The typical dense wheel-shaped structure can not be seen, and most of them are myxoma-like.

Clinical symptoms

It is slightly more common in males and can occur at any age, most commonly in middle age, and rarely in children. The tumor manifests as a raised hard mass with multiple nodules, which are light red or blue-purple. The lesions are progressively larger and may coalesce, sometimes leafy, with a slightly smooth surface, and grow slowly. Usually attached to the upper epidermis, but rarely to deeper tissues. Generally asymptomatic. Individuals have mild or moderate pain. May ulcerate and bleed after minor trauma. Usually solitary, more common in the trunk, more common in the chest, followed by the extremities, but can occur in any part of the body. The disease period can be as long as 50 years. In addition to the raised surface, this tumor can also be used for invasive growth, invading the subcutaneous tissue. If the excision is not clean, local recurrence may occur. Although there are also metastases to the lung, abdomen, brain, bone or nearby lymph nodes, they are uncommon and only appear in the late stage, often the result of multiple local recurrences. The transfer period ranges from 1 to 33 years.