The Sarcomas

  • Aaron M. Bruce
  • James M. Spencer


  • EPIDEMIOLOGY: Collectively uncommon with exception of AFX, seen principally in elderly, equal gender.

  • PATHOGENESIS: AFX and AS–UV light, DFSP-translocation of PDGF and collagen genes t(17;22).

  • PATHOLOGY: AFX-storiform, anaplasia; DFSP-storiform, no anaplasia; LS-fascicles; AS-anastomosing sinusoids.

  • CLINICAL: AFX-face, ulcerated papule; DFSP-nodule trunk and exts.; LS-nodules; AS- face violaceous patch.


Spindle Cell Collagen Gene Malignant Fibrous Histiocytoma Fibrous Histiocytoma Deep Soft Tissue 



  1. 1.
    Gloster HM Jr, Harris KR, Roenigk RK. A comparison between Mohs micrographic surgery and wide surgical excision for the treatment of dermatofibrosarcoma protuberans. J Am Acad Dermatol. 1996 Jul;35(1):82–87. Review.PubMedGoogle Scholar
  2. 2.
    Nouri K, Lodha R, Jimenez G, Robins P. Mohs micrographic surgery for dermatofibrosarcoma protuberans: University of Miami and NYU experience. Dermatol Surg. 2002 Nov;28(11):1060–1064; discussion 1064.CrossRefPubMedGoogle Scholar
  3. 3.
    Massey RA, Tok J, Strippoli BA, Szabolcs MJ, Silvers DN, Eliezri YD. A comparison of frozen and paraffin sections in dermatofibrosarcoma protuberans. Dermatol Surg. 1998 Sep;24(9):995–998.CrossRefPubMedGoogle Scholar
  4. 4.
    Ratner D, Thomas CO, Johnson TM, Sondak VK, Hamilton TA, Nelson BR, Swanson NA, Garcia C, Clark RE, Grande DJ. Mohs micrographic surgery for the treatment of dermatofibrosarcoma protuberans. Results of a multinstitutional series with an analysis of the extent of microscopic spread. J Am Acad Dermatol. 1997 Oct;37(4):600–613.CrossRefPubMedGoogle Scholar
  5. 5.
    Snow SN, Gordon EM, Larson PO, Bagheri MM, Bentz ML, Sable DB. Dermatofibrosarcoma protuberans: a report on 29 patients treated by Mohs micrographic surgery with long-term follow-up and review of the literature. Cancer. 2004 Jul 1;101(1):28–38.CrossRefPubMedGoogle Scholar


  1. 6.
    Brown MD, Swanson NA. Treatment of malignant fibrous histiocytoma and atypical fibrous xanthomas with micrographic surgery. J Dermatol Surg Oncol. 1989 Dec;15(12):1287–1292.PubMedGoogle Scholar
  2. 7.
    Davis JL, Randle HW, Zalla MJ, Roenigk RK, Brodland DG. A comparison of Mohs micrographic surgery and wide excision for the treatment of atypical fibroxanthoma. Dermatol Surg. 1997 Feb;23(2):105–110.CrossRefPubMedGoogle Scholar


  1. 8.
    Bernstein SC, Roenigk RK. Leiomyosarcoma of the skin. Treatment of 34 cases. Dermatol Surg. 1996 Jul;22(7):631–635. Review.CrossRefPubMedGoogle Scholar
  2. 9.
    Huether MJ, Zitelli JA, Brodland DG. Mohs micrographic surgery for the treatment of spindle cell tumors of the skin. J Am Acad Dermatol. 2001 Apr;44(4):656–659.CrossRefPubMedGoogle Scholar
  3. 10.
    Humphreys TR, Finkelstein DH, Lee JB. Superficial leiomyosarcoma treated with Mohs micrographic surgery. Dermatol Surg. 2004 Jan;30(1):108–112.CrossRefPubMedGoogle Scholar


  1. 11.
    Muscarella VA. Angiosarcoma treated by Mohs micrographic surgery. J Dermatol Surg Oncol. 1993 Dec;19(12):1132–1133.PubMedGoogle Scholar
  2. 12.
    Goldberg DJ, Kim YA Angiosarcoma of the scalp treated with Mohs micrographic surgery. J Dermatol Surg Oncol. 1993 Feb;19(2):156–158.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Aaron M. Bruce
    • 1
  • James M. Spencer
    • 2
    • 3
  1. 1.Department of Dermatology, Suncoast HospitalNova Southeastern UniversityLargoUSA
  2. 2.Clinical Dermatology, Mount Sinai School of MedicineNew YorkUSA
  3. 3.Spencer Dermatology and Surgery CenterSt. PetersburgUSA

Personalised recommendations