Giant Dermatofibrosarcoma Protuberans With Bilateral Orbital Involvement

Ophthalmic Plast Reconstr Surg. 2019 Mar/Apr;35(2):e36-e39. doi: 10.1097/IOP.0000000000001308.

Abstract

Dermatofibroma sarcoma protuberans (DFSP) is a rare, locally aggressive soft tissue sarcoma with a tendency for recurrence after excision. Although reports of unilateral orbital and bilateral eyelid disease exist, there have been no prior reports of DFSP with bilateral orbital involvement and no previously described cases of DFSP associated with transient optic neuropathy. The authors present a case report of a 34-year-old woman with a giant scalp DFSP involving the bilateral orbits. Despite radical resection with 5 cm margins where possible, multiple positive margins remained including deep positive margins at the bilateral superomedial retroseptal soft tissue. The patient completed adjuvant radiation for surgically unresectable disease. This case highlights the challenge of achieving local control given the disease extent and infiltration of the bilateral eyelids and orbits. This is the first reported case of DFSP with bilateral orbital involvement and associated transient optic neuropathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Combined Modality Therapy
  • Dermatofibrosarcoma / diagnosis*
  • Dermatofibrosarcoma / therapy
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasm Invasiveness
  • Orbital Neoplasms / pathology*
  • Orbital Neoplasms / therapy
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / therapy