Dermatopathology
Tumor in the plantar region: dermatofibrosarcoma protuberans in an infrequent topography
Simone Perazzolia,
, Renan Rangel Bonamigob,c, Renata Hecka, André da Silva Cartellb,d
Corresponding author
a Sanitary Dermatology Outpatient Clinic, Porto Alegre, RS, Brazil
b Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
c Sanitary Dermatology Service, Secretaria Estadual de Saúde do Estado do Rio Grande do Sul e Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
d Medical Residence in Pathological Anatomy, Hospital de Clínicas, Porto Alegre, RS, Brazil
Read
5875
Timeswas read the article
2835
Total PDF
3040
Total HTML
Share statistics
array:24 [ "pii" => "S0365059620302099" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.05.002" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "246" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:18 [ "pii" => "S2666275220302873" "issn" => "26662752" "doi" => "10.1016/j.abdp.2020.09.001" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "246" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "pt" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Dermatopatologia</span>" "titulo" => "Tumor na região plantar: dermatofibrossarcoma <span class="elsevierStyleItalic">protuberans</span> em topografia infrequente" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "728" "paginaFinal" => "730" ] ] "contieneResumen" => array:1 [ "pt" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 589 "Ancho" => 905 "Tamanyo" => 155903 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Imuno‐histoquímica: positividade difusa para CD34 nas células fusiformes de padrão estoriforme.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Simone Perazzoli, Renan Rangel Bonamigo, Renata Heck, André da Silva Cartell" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Simone" "apellidos" => "Perazzoli" ] 1 => array:2 [ "nombre" => "Renan Rangel" "apellidos" => "Bonamigo" ] 2 => array:2 [ "nombre" => "Renata" "apellidos" => "Heck" ] 3 => array:2 [ "nombre" => "André da Silva" "apellidos" => "Cartell" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059620302099" "doi" => "10.1016/j.abd.2020.05.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302099?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302873?idApp=UINPBA00008Z" "url" => "/26662752/0000009500000006/v1_202012150903/S2666275220302873/v1_202012150903/pt/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0365059620302191" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.05.003" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "256" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "rev" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Azathioprine: its uses in dermatology" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "731" "paginaFinal" => "736" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 957 "Ancho" => 2167 "Tamanyo" => 105386 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Azathioprine metabolism.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sonia Chavez-Alvarez, Maira Herz-Ruelas, Alejandra Villarreal-Martinez, Jorge Ocampo-Candiani, Rubicela Garza-Garza, Minerva Gomez-Flores" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Sonia" "apellidos" => "Chavez-Alvarez" ] 1 => array:2 [ "nombre" => "Maira" "apellidos" => "Herz-Ruelas" ] 2 => array:2 [ "nombre" => "Alejandra" "apellidos" => "Villarreal-Martinez" ] 3 => array:2 [ "nombre" => "Jorge" "apellidos" => "Ocampo-Candiani" ] 4 => array:2 [ "nombre" => "Rubicela" "apellidos" => "Garza-Garza" ] 5 => array:2 [ "nombre" => "Minerva" "apellidos" => "Gomez-Flores" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275220302976" "doi" => "10.1016/j.abdp.2020.09.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302976?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302191?idApp=UINPBA00008Z" "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302191/v2_202011230629/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059620302312" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.05.005" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "268" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Acute bullous hemorrhagic prurigo: a diagnostic challenge" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "724" "paginaFinal" => "727" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 766 "Ancho" => 905 "Tamanyo" => 73932 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Blisters on the hands of a patient who identified the stings as being from horseflies. Some have hemorrhagic content and a central point where the bite occurred. Photography: Sílvia Mitiko Nishima.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Vidal Haddad Jr, Cecília Guimarães Ferreira Fonseca, Adriana Lúcia Mendes" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Vidal" "apellidos" => "Haddad Jr" ] 1 => array:2 [ "nombre" => "Cecília Guimarães Ferreira" "apellidos" => "Fonseca" ] 2 => array:2 [ "nombre" => "Adriana Lúcia" "apellidos" => "Mendes" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S266627522030309X" "doi" => "10.1016/j.abdp.2020.05.020" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S266627522030309X?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302312?idApp=UINPBA00008Z" "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302312/v2_202011230629/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Dermatopathology</span>" "titulo" => "Tumor in the plantar region: dermatofibrosarcoma protuberans in an infrequent topography" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "728" "paginaFinal" => "730" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Simone Perazzoli, Renan Rangel Bonamigo, Renata Heck, André da Silva Cartell" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Simone" "apellidos" => "Perazzoli" "email" => array:1 [ 0 => "simone_perazzoli@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Renan Rangel" "apellidos" => "Bonamigo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Renata" "apellidos" => "Heck" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "André da Silva" "apellidos" => "Cartell" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Sanitary Dermatology Outpatient Clinic, Porto Alegre, RS, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Sanitary Dermatology Service, Secretaria Estadual de Saúde do Estado do Rio Grande do Sul e Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Medical Residence in Pathological Anatomy, Hospital de Clínicas, Porto Alegre, RS, Brazil" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 497 "Ancho" => 905 "Tamanyo" => 38363 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Exophytic and ulcerated tumor lesion.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Dermatofibrosarcoma protuberans (DFSP) is a mesenchymal neoplasm of slow growth, locally aggressive and with low metastatic potential. It has several presentations and can be characterized as a hardened plaque, nodule, or vegetating lesion.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Local trauma has been described as a potential risk factor for tumor onset.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The most common sites of involvement are the trunk (40%–50%), the proximal limbs (30%–40%), and the head and cervical region (10%–15%). In the literature review, 11 reports of tumors located in the plantar region were retrieved. Due to the rarity of the presentation on the distal limbs, the authors believe that reporting this case is relevant.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">Male patient, 35 years old, previously healthy, complained of painful lesion on the left plantar region with progressive growth over six months; he denied trauma. On physical examination, he presented an erythematous, exophytic, vegetating, and ulcerated tumor on the first metatarsal joint (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Histopathological examination of the lesion revealed a fusocellular proliferation with a focal storiform pattern (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). In the immunohistochemical study, a diffuse positivity for CD34<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>cells was observed. The findings were compatible with low-grade fusocellular mesenchymal neoplasia, favoring the diagnosis of DFSP (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Surgical treatment involved amputation of the hallux and part of the left forefoot; no tumor recurrence was observed after four months of post-operative follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">DFSP is a rare mesenchymal tumor with low rates of aggressiveness. It presents slow progression, with high rates of local recurrence and rare cases of distant metastases. An American study conducted between 2000 and 2010 found an incidence of 41 cases in 10 million patients.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Some studies observed a higher incidence in women and black people. It mostly affects the trunk (40%–50%), the proximal limbs (30%–40%), and the head and cervical region (10%–15%).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A literature review published in 2019 described 11 cases of dermatofibrosarcoma that affected the feet. The mean age observed was 41 years; it was more frequent in men than in women (8:3) and the most frequent location of the tumor was the dorsum of the feet. The mean growth period was 3.5 years. The mean DFSP size at diagnosis was approximately 3.5<span class="elsevierStyleHsp" style=""></span>cm. Clinical diagnosis is difficult given the variety of presentations. Dermoscopy has been described as a useful tool to aid diagnosis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> In a review based on the analysis of 32 dermatofibrosarcomas, the most common features described in dermoscopy were the presence of vessels (81%), followed by a pigment network (78%) and a pinkish background (66%).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Histologically, dermatofibrosarcoma presents monomorphic spindle cells with little atypia and mitotic activity, arranged in irregular and multidirectional (storiform) fascicles. The tumor infiltrates the subcutaneous tissue, creating the characteristic honeycomb pattern. The histological differential diagnoses of other spindle cell tumors are dermatofibroma, malignant fibrous histiocytoma, atypical fibroxanthoma, desmoplastic melanoma, Kaposi's sarcoma, and solitary fibrous tumor.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Immunohistochemistry becomes an important resource for differential diagnosis, as DFSP is positive for CD34 and negative for S 100 protein, factor XIIIA, and desmin.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> All the cases described in the literature were tested for CD34 and were positive.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The recommended treatment is lesion excision with 2–3<span class="elsevierStyleHsp" style=""></span>cm of safety margins.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Involvement of margins is associated with local recurrence.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Another therapeutic option is Mohs micrographic surgery. Management with radiotherapy and imatinib has been described. The use of imatinib is indicated for metastases, local recurrences, as neoadjuvancy, or when the tumor is unresectable.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Attention should be paid to this disease, even in unusual anatomical areas, as the prognosis depends on the early diagnosis and treatment.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors’ contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Simone Perazzoli: Conception and planning of the study; elaboration and writing of the manuscript; critical review of the literature.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Renan Rangel Bonamigo: Approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; obtaining, analyzing, and interpreting the data; effective participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Renata Heck: Approval of the final version of the manuscript; conception and planning of the study; elaboration and writing of the manuscript; obtaining, analyzing, and interpreting the data; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases.</p><p id="par0065" class="elsevierStylePara elsevierViewall">André da Silva Cartell: Approval of the final version of the manuscript; conception and planning of the study; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1418418" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1297627" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Financial support" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Authors’ contributions" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-01-27" "fechaAceptado" => "2020-05-02" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1297627" "palabras" => array:3 [ 0 => "Dermatofibrosarcoma" 1 => "Immunohistochemistry" 2 => "Sarcoma" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dermatofibrosarcoma protuberans is a rare mesenchymal tumor; it is locally aggressive and presents high rates of local recurrence. It may present as a nodular or plaque vegetating lesion. It mainly affects the trunk and proximal limbs, being rare in the distal extremities. Biopsy and immunohistochemistry help confirm the diagnosis. The authors report a case of dermatofibrosarcoma protuberans with plantar region involvement, a rare presentation. To the best of the authors’ knowledge, only 11 cases of involvement of the feet were described in the international literature.</p></span>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Perazzoli S, Bonamigo RR, Heck R, Cartell AS. Tumor in the plantar region: dermatofibrosarcoma protuberans in an infrequent topography. An Bras Dermatol. 2020. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.abd.2020.05.002">https://doi.org/10.1016/j.abd.2020.05.002</span></p>" ] 1 => array:2 [ "etiqueta" => "⋆⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Sanitary Dermatology Outpatient Clinic, Porto Alegre, RS, Brazil.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 497 "Ancho" => 905 "Tamanyo" => 38363 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Exophytic and ulcerated tumor lesion.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 716 "Ancho" => 905 "Tamanyo" => 167606 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathology: fusocellular proliferation with a focal storiform pattern (Hemathoxylin & eosin ×40).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 589 "Ancho" => 905 "Tamanyo" => 155903 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemistry: diffuse positivity for CD34 in spindle cells with storiform pattern.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermoscopy of dermatofibrosarcoma protuberans: what do we know?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F.G. Escobar" 1 => "C.K. Ribeiro" 2 => "L.L. Leite" 3 => "C.R. Barone" 4 => "A. Cartell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5826/dpc.0902a10" "Revista" => array:6 [ "tituloSerie" => "Dermatol Pract Concept" "fecha" => "2019" "volumen" => "9" "paginaInicial" => "139" "paginaFinal" => "145" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31106017" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibrosarcomatous dermatofibrosarcoma protuberans from scar following trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.W. Lee" 1 => "A. Zaesim" 2 => "A. Jackson" 3 => "M. Borkat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4322/acr.2018.039" "Revista" => array:5 [ "tituloSerie" => "Autops Case Rep" "fecha" => "2018" "volumen" => "8" "paginaInicial" => "e2018039" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30775318" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatofibrosarcoma protuberans on adult toes: a case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Madden" 1 => "A. Spector" 2 => "S. Siddiqui" 3 => "G. Mirkin" 4 => "J. Yim" 5 => "X. Hao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21873/anticanres.13323" "Revista" => array:6 [ "tituloSerie" => "Anticancer Res" "fecha" => "2019" "volumen" => "39" "paginaInicial" => "2105" "paginaFinal" => "2111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30952756" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk-stratified surveillance in dermatofibrosarcoma protuberans: less is more" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.A. Gladdy" 1 => "J.S. Wunder" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.31922" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2019" "volumen" => "125" "paginaInicial" => "670" "paginaFinal" => "672" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30644529" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imatinib treatment for locally advanced or metastatic dermatofibrosarcoma protuberans: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Navarrete-Dechent" 1 => "S. Mori" 2 => "C.A. Barker" 3 => "M.A. Dickson" 4 => "K.S. Nehal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2018.4940" "Revista" => array:6 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2019" "volumen" => "155" "paginaInicial" => "361" "paginaFinal" => "369" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30601909" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302099/v2_202011230629/en/main.assets" "Apartado" => array:4 [ "identificador" => "80636" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Dermatopathology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009500000006/v2_202011230629/S0365059620302099/v2_202011230629/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302099?idApp=UINPBA00008Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 14 | 7 | 21 |
| 2024 October | 75 | 64 | 139 |
| 2024 September | 120 | 90 | 210 |
| 2024 August | 129 | 109 | 238 |
| 2024 July | 126 | 107 | 233 |
| 2024 June | 111 | 69 | 180 |
| 2024 May | 81 | 61 | 142 |
| 2024 April | 85 | 85 | 170 |
| 2024 March | 67 | 65 | 132 |
| 2024 February | 80 | 87 | 167 |
| 2024 January | 49 | 38 | 87 |
| 2023 December | 61 | 63 | 124 |
| 2023 November | 70 | 83 | 153 |
| 2023 October | 49 | 65 | 114 |
| 2023 September | 61 | 65 | 126 |
| 2023 August | 50 | 31 | 81 |
| 2023 July | 47 | 31 | 78 |
| 2023 June | 48 | 45 | 93 |
| 2023 May | 51 | 15 | 66 |
| 2023 April | 38 | 14 | 52 |
| 2023 March | 66 | 56 | 122 |
| 2023 February | 53 | 22 | 75 |
| 2023 January | 64 | 38 | 102 |
| 2022 December | 41 | 24 | 65 |
| 2022 November | 64 | 54 | 118 |
| 2022 October | 146 | 52 | 198 |
| 2022 September | 38 | 63 | 101 |
| 2022 August | 39 | 43 | 82 |
| 2022 July | 40 | 50 | 90 |
| 2022 June | 40 | 63 | 103 |
| 2022 May | 41 | 61 | 102 |
| 2022 April | 43 | 52 | 95 |
| 2022 March | 49 | 67 | 116 |
| 2022 February | 23 | 38 | 61 |
| 2022 January | 51 | 77 | 128 |
| 2021 December | 34 | 50 | 84 |
| 2021 November | 37 | 59 | 96 |
| 2021 October | 48 | 73 | 121 |
| 2021 September | 26 | 36 | 62 |
| 2021 August | 38 | 55 | 93 |
| 2021 July | 40 | 43 | 83 |
| 2021 June | 40 | 56 | 96 |
| 2021 May | 81 | 78 | 159 |
| 2021 April | 216 | 234 | 450 |
| 2021 March | 99 | 97 | 196 |
| 2021 February | 31 | 23 | 54 |
| 2021 January | 40 | 18 | 58 |
| 2020 December | 42 | 23 | 65 |
| 2020 November | 24 | 8 | 32 |
| 2020 October | 11 | 7 | 18 |
| 2020 September | 19 | 17 | 36 |
| 2020 August | 4 | 4 | 8 |
Show all
