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Pleomorphic dermal sarcoma: a retrospective study of 16 cases in a dermato-oncology centre and a review of the literature

  • Investigative Report
  • Published:
European Journal of Dermatology

Abstract

Background

Relatively little is known about the true aggressive potential of pleomorphic dermal sarcoma (PDS) or optimal management strategies.

Objective

To describe the outcomes of 16 cases of PDS treated at our hospital (14 with modified Mohs micrographic surgery [M-MMS] and two with conventional surgery) and establish an adequate plan for management.

Materials & Methods

We reviewed 16 PDS cases treated at our hospital between October 2007 and June 2019 and compared our results with the available evidence.

Results

In total, 69% of cases had recurred after initial conventional surgery, M-MMS led to local disease control in 83% of cases, and 19% of patients developed metastasis. Combining all published PDS cases with ours, we calculated an overall metastasis rate of 12%, and an overall recurrence rate of 35% after conventional surgery and 17% after M-MMS.

Conclusion

PDS is more aggressive than previously estimated, with an overall metastatic rate of 12%. Despite high recurrence rates with previous conventional surgery (69%), M-MMS achieved a good rate of local disease control (83%). Given the potential aggressivity of PDS and the importance of clear surgical margins, M-MMS appears to be more adequate than conventional excision. Staging studies and close monitoring are warranted in PDS patients, for which we propose a management algorithm.

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Author information

Authors and Affiliations

  1. Department of Dermatology, Instituto Valenciano de Oncología. Valencia, Valencia, Spain

    Elisa Ríos-Viñuela, Carlos Serra-Guillén, Beatriz Llombart, Celia Requena, Eduardo Nagore, Carlos Guillén, Diego Vázquez & Onofre Sanmartín

  2. Department of Pathology, Instituto Valenciano de Oncología. Valencia, Valencia, Spain

    Victor Traves

Authors
  1. Elisa Ríos-Viñuela
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  2. Carlos Serra-Guillén
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  3. Beatriz Llombart
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  4. Celia Requena
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  5. Eduardo Nagore
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  6. Victor Traves
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  7. Carlos Guillén
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  8. Diego Vázquez
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  9. Onofre Sanmartín
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Correspondence to Elisa Ríos-Viñuela.

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Ríos-Viñuela, E., Serra-Guillén, C., Llombart, B. et al. Pleomorphic dermal sarcoma: a retrospective study of 16 cases in a dermato-oncology centre and a review of the literature. Eur J Dermatol 30, 545–553 (2020). https://doi.org/10.1684/ejd.2020.3875

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  • DOI: https://doi.org/10.1684/ejd.2020.3875

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