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This question was answered on Sat 20, Sep 2008 09:24am by Dr Paul S, MD

dermatofibrosarcoma protuberans question about surgery for wide excision


    
Asked by hungry4info (Female; 54; diabetes, hypertension, both well controlled; Relevant drugs:Metformin 500 BID, Vasotec 5.0 mg QD ) on Thu 18, Sep 2008 09:43am

On 9/2/08, I had a cyst removed from the right medial elbow region, learned on 9/17/08 that pathology showed a dermatofibrosarcoma protuberans. Pathology report showed scattered mitotic activity and invasion around collagen and extending into the bordering adipose tissue. Also states "tumor appears to focally extend to specimen margins" We are in process of obtaining a reading from a dermatopathologist now, and anticipate that a wide excision up to 2 cm margins will be needed. The surgeon who removed the nodule is an orthopedic upper extremity specialist. I have been told it may be beneficial to consider having an oncology surgeon do the wide excision. Would appreciate your opinion as to which type of specialist should do the surgery, or if the main issue will be who reads the next pathology report. Thank you for your time.
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Answer by Dr Paul S, MD  on Sat 20, Sep 2008 09:24am:

Hi there. From my point of view, I believe that your best option would be a collaboration of the expertise of both of these surgeons since the management of these types of tumors should really entail a multidisciplinary approach. It is important for these tumors to have a clear margin as this is your best chance of preventing a recurrence or a spread of the tumor. Invoking the multidisciplinary approach further, I believe there is a role for additional adjuvant treatment with radiation therapy after obtaining negative surgical margins, or with drugs such as imatinib mesylate (gleevec). I suggest you discuss these other options further with your doctors. Regards and I hope adequate margins can be obtained.

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Comment by hungry4info on Sun 21, Sep 2008 02:46pm: Thank you so much for your input, I appreciate it. I am praying for clear margins as well, we will see what the future holds.

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