A case report of dermatofibrosarcoma protuberans with osteolytic.

BACKGROUND

Dermatofibrosarcoma protuberans (DFSP) is a rare, low-to-intermediate grade malignant soft tissue sarcoma that is prone to local recurrence after surgery but rarely metastasizes to distant sites. However, in this case, the tumor metastasized to the humerus and presented as a solitary lesion.

CASE PRESENTATION: A 42-year-old male patient presented with pain and limited mobility in the left upper limb, with a history of surgery for DFSP in the popliteal fossa. Imaging examinations revealed bone destruction in the proximal humerus and a soft tissue mass, with the lesion measuring 11.0 × 8.5 × 7.0 cm. Aspiration biopsy confirmed that the lesion in the humerus was a metastatic tumor. After two months of palliative treatment, follow-up examinations showed a reduction in the size of the lesion.Seven months after the treatment, the humeral lesion had progressed, and multiple new bone metastases were found.

CONCLUSIONS

Metastasis of DFSP is rare, and bone metastasis is even rarer. We need to integrate medical history, perform comprehensive diagnosis through immunohistochemistry, molecular pathology monitoring, and imaging examinations. Additionally, this case reminds us that when encountering patients who primarily complain of bone pain during the initial diagnosis, we should thoroughly inquire about their medical and surgical history, conduct a comprehensive analysis, and make an integrated judgment. When necessary, perform a core biopsy first to determine the origin of the lesion. This approach allows us to provide patients with as comprehensive a range of treatment options as possible, thereby improving their quality of life.