Accelerated growth of postradiation dermatofibrosarcoma protuberans in left subaxillary region during pregnancy:a case report / 中华皮肤科杂志

ABSTRACT

A 30-year-old woman presented with a 5-year history of recurrent nodular lesions in the left subaxillary region,which had rapidly grown for 7 weeks.Five years prior to the presentation,she received breast conservation surgery and radiotherapy for left breast cancer,thereafter,chronic radiation dermatitis developed in the left subaxillary region.Two years after the operation,three soybean-sized bright red nodules appeared in the lesions of radiation dermatitis,and slowly enlarged.Subsequently,the nodules were resected,but a local recurrence was observed 3 weeks after the resection.The recurrent masses underwent accelerated growth during her pregnancy,and the growth was obviously inhibited after the termination of pregnancy.Physical examination revealed a quasi-elliptic,dark or bright red plaque measuring about 18 cm × 14 cm with a smooth surface in left subaxillary region,and in the center of the plaque was a bright red,hemispheric,elevated lesion measuring 10 cm × 9 cm × 5 cm with erosions or pitchy crusts on the surface.Histopathology of the lesions showed that the tumor was located in the dermis and consisted of densely packed uniform spindle-shaped cells arranged in a characteristic storiform or whirlpool pattern.Some cell nuclei showed atypia,and few mitoses were observed.In some parts of the lesion,tumor cells were arranged in a herringbone pattern.Immunohistochemistry revealed that the tumor cells stained positive for vimentin(strongly)and actin(weakly),but negative for CD34.Based on these findings,a diagnosis of postradiation dermatofibrosarcoma protuberans(fibrosarcoma type)was made.