Age / Sex : 32 / M

Chief complaint : Protruding mass, left supraclavicular area, duration 6months

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : 이신우 (Sheen-Woo Lee), 가천의대 길병원 (Gachon University Gil Hospital)

Dermatofibrosaroma Protuberans

Discussion

Findings:

Lobular lesion, with nonspecific MR signal intensity (Isosignal intensity on T1WI, high signal intensity of T2WI, diffuse homogeneous enhancement).

 
Differential Diagnosis:

Lymphoma.

Angiomyxoma (but it favors pelvic and perineal area).

 Epidermoid cyst (but it does not have internal contrast enhancement).

Discussion:

Dermatofibrosaroma Protuberans

• Low grade superficial malignancy


• Approximately 6% of all soft tissue sarcoma


• Third to fifth decade of life, M>F


• Frequently involve the trunk (50%), proximal upper and lower extremities(20 to 40%)


• Local recurrence rate high (10 to 60%), due to infiltration of the lesion, not detected at initial surgical resection.


• Low rate of distant metastases (0.5 to 6%)


• Known to have Linear extension along the skin surface or satellite nodule in adjacent soft tissue (lacking in this case)

References:

 Dermatofibrosarcoma Protuberans: MR Imaging Features. AJR 2002;178:989–993