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Anne Han, MD; Elbert H. Chen, MD; George Niedt, MD; William Sherman, MD; Désirée Ratner, MD

Arch Dermatol. 2009;145(7):792-796.

Background  Dermatofibrosarcoma protuberans (DFSP) is an unusual soft-tissue tumor with a propensity for subclinical extension and local recurrence. Surgical excision, even with tissue-sparing techniques, may cause significant deformity or disability because of the infiltrative nature of DFSP. In this study, we evaluate retrospective data obtained from 4 patients with locally advanced or recurrent DFSP who received neoadjuvant imatinib mesylate therapy before undergoing Mohs micrographic surgery.

Observations  Patients treated with neoadjuvant imatinib therapy had an average tumor size reduction of 36.9%. This clinical response was paralleled by histopathologic changes, including decreased cellularity in 100% of the total area as well as significant hyalinization. Imatinib therapy for DFSP before Mohs micrographic surgery was associated with 100% local control at a maximum follow-up of 4 years.

Conclusions  Neoadjuvant imatinib therapy is a well-tolerated, novel approach to DFSP that reduces tumor burden and facilitates resection. Larger prospective studies are needed to confirm and expand on these results.

Author Affiliations: Departments of Dermatology (Drs Han, Niedt, and Ratner) and Medicine–Oncology (Dr Sherman), Columbia University Medical Center, New York, New York; and Kaiser Permanente, Rancho Cordova, California (Dr Chen).

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