Two cases of recurrent dermatofibrosarcoma protuberans treated by Mohs micrographic surgery

Dermatofibrosarcoma protuberans (DFSP) is an uncommon recurrent soft-tumor of skin and is locally highly invasive and aggressive, although it rarely metastasizes. When possible, of the many treatment modalities, the surgical excision is indicated primarily. There are three surgical modalities, which are excision with undefined or conservative surgical margins, excision with wide surgical margins and Mohs micrographic surgery (MMS). And the classical standard surgery was the local wide excision with at least 3cm margin around the primary tumor and through the deep fascia. However recent studies has showed that MMS decreased the recurrent rate of the tumor, conserving the normal uninvolved tissue, and MMS is accepted as the first choice treatment modality of DFSP. Some studies reported that the margin of 2.5cm is necessary to clear the tumor in MMS. We present two cases of recurrent DFSP treated by Mohs micrographic surgery, one through 4-staged resection, the other, 3-staged resection of the tumor.