Mohs Surgery Best for Removing DFSP?

Is Mohs surgery the best option or the gold standard for re-excision of a rather small (2x2x2 cm at primary removal) DFSP on the back?

Doctor Answers 6

Mohs plus permanent section borders for DFSP.

Dermatofibrosarcoma Protuberans (DFSP) is an invasive and difficult tumor to remove. It is best to treat it with respect and first perform Mohs surgery with a qualified and very experienced Mohs surgeon, and then follow the Mohs clear margins with one extra layer to be processed for permanent sections with special stains at an outside lab, for definitive clearance.

New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Mohs is excellent for DFSP

DFSP is a less common type of skin cancer that often times spreads beyond what is seen on the skin surface and as a result has a higher recurrence rate than other common tumors..  Because of this, Mohs surgery is ideal for tracking these tumors as they spread through the tissues and minimizing the chance of recurrence.

Edgar Franklin Fincher, MD, PhD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 1 review

Mohs surgery is the gold standard for dermatofibrosarcoma protuberans (DFSP)

Dermatofibrosarcoma protuberans otherwise known as DFSP clinically can be non-descript, such a brown bump on back or extremities. However, DFSP is typically quite insidious with very indistinct margins, even under microscope. Mohs micrographic surgery should be considered for DFSP as it is the best procedure to ensure clear margins with smallest defect possible.

William Ting, MD
Bay Area Dermatologic Surgeon
4.8 out of 5 stars 12 reviews

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Mohs for DFSP

Yes. It is the gold standard as these neoplasms can involve the margins with standard excisions. Many Mohs surgeons often excise an additional layer of skin around the negative frozen section Mohs defect and submit it to a dermatopathology laboratory for permanent section analysis. Special stains may be performed to see if there are any residual cells at the margin. Some may even do these stains in their Mohs labs on frozen sections but they may be of the minority of Mohs surgeons. When Mohs is not possible, a wide excision is necessary involving many stepsections performed by the pathologist to determine margin clearance.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Mohs Surgery for DFSP

DermatoFibrosarcoma Protuberans (DFSP) is not as common as other skin cancers treated with Mohs Surgery. Mohs Surgery is an excellent option for this tumor because it can often extend beyond the visible clinical margin of the tumor. Historically DFSPs have had very high local recurrence rates. Because of the precise control removing the tumor Mohs Surgery is an excellent option.

Jerome Potozkin, MD
Danville Dermatologic Surgeon
4.2 out of 5 stars 5 reviews

Mohs surgery for DFSP

Good question. DFSP or dermatofibrosarcoma protuberans is a tumor that can send out long "tentacles." It is also a contiguous/continuous tumor which makes it amenable to Mohs surgery. Mohs surgery allows for excellent margin control and is in fact the best option for treating DFSP because it results in the highest cure rate.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.