J Korean Soc Radiol.  2013 May;68(5):417-421.

Axillary Metastasis in the Abdominal Dermatofibrosarcoma Protuberans with the Fibrosarcomatous Changes: A Case Report

• Kim SJ
• Jung HK
• Kim KI

Abstract

Most distant metastases of dermatofibrosarcoma protuberans (DFSP) occurs with the repeated local recurrences and mainly in the lungs. Focusing on the imaging features, we report a unique occurrence of the distant metastasis of DFSP with fibrosarcomatous changes to the axillary soft tissue without previous local recurrences, possibly misdiagnosed as the accessory breast cancer.

MeSH Terms

Breast Neoplasms
Dermatofibrosarcoma
Lung
Magnetic Resonance Imaging
Neoplasm Metastasis
Recurrence
Dermatofibrosarcoma

Figure

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  Fig. 1 A postoperative routine chest CT axial image revealed a 2 cm sized round and solid nodule with mild homogenous enhancement in the left axilla (arrow). Pulmonary metastasis was absent and no locally recurred evidences were found on chest and abdominal CT scans.

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  Fig. 2 Physical examination showed postoperative scar in the left abdominal skin and focal bulding with a blue skin color change in the left axilla (arrow).

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  Fig. 3 A 2.1 × 1.9 cm sized irregular and hypoechoic mass with a hyperechoic rim (arrows) was seen at the left axillary subcutaneous fat layer on ultrasound.

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  Fig. 4 Mammography showed a round and hyperdense nodular density in the left axilla (arrow) without other remarkable features.

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  Fig. 5 A post-contrast fat-suppressed T1 weighted MR axial image demonstrated a peripherally enhancing solid tumor with internal necrosis invading the skin and the pectoralis major muscle at the left anterior axillary region (arrows).

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  Fig. 6 The final pathologic results confirmed metastatic dermato fibrosarcoma protuberans with fibrosarcomatous changes. A. Pathologic specimen of an initial abdominal lesion showed sarcomatous changes (arrows) in dermatofibrosarcoma protuberans arising in the dermis (hematoxylin-eosin, × 12). B. Pathologic specimen of a recurrent axillary lesion showed similar histologic freatures of sarcomatous changes in dermatofibrosarcoma protuberans (arrows) locating in subcutaneous fatty layer (hematoxylin-eosin, × 12).

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