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Life
Volume 15
Issue 7
10.3390/life15071025
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Overcoming Mohs Limitations in Treating DFSP: Retrospective Analysis of a Novel Excision Technique

by
Rami Shoufani
1,2,
Ariel Berl
1,2,
Ofir Shir-az
1,2,
Deborah Kidron
2,3,
Din Mann
1,2,
Noam Castel
1,2 and
Avshalom Shalom
1,2,*
1
Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428163, Israel
2
Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
3
Department of Pathology, Meir Medical Center, Kfar Saba 4428163, Israel
*
Author to whom correspondence should be addressed.
Life 2025, 15(7), 1025; https://doi.org/10.3390/life15071025 (registering DOI)
Submission received: 16 May 2025 / Revised: 23 June 2025 / Accepted: 25 June 2025 / Published: 27 June 2025
(This article belongs to the Special Issue Advances in Skin-Related Disease: Pathogenesis and Novel Therapeutic Strategies)
Versions Notes

Abstract

Dermatofibrosarcoma protuberans (DFSP) is a rare, soft-tissue sarcoma characterized by dermal, finger-like projections and high local recurrence rates. Complete surgical excision is the primary treatment goal and Mohs micrographic surgery (MMS) is the accepted approach for achieving disease-free margins. Despite the effectiveness of MMS, it has limitations when treating DFSP, with documented local recurrences. This paper presents our experience and treatment modality for DFSP, using MMS with an additional “safety margin”. This technique seeks to ensure free surgical margins and potentially lower recurrence rates. This is a retrospective analysis of patients treated for DFSP over a 10-year period. All patients underwent MMS, followed by an additional, circumferential excision of 2–5 mm. Twenty-two patients were treated surgically for DFSP from 2014 to 2023. The median age at presentation was 42.5 years. Four patients (18%) had positive disease margins on the additional safety marginal excision, two had negative MMS slides, and the other two were positive for DFSP. The mean follow-up time was 27 months, and no local recurrences were observed during that time. The surgical method presented here includes an additional excision of the surrounding margins following MMS for DFSP. This technique provides a tool to overcome the limitations of MMS in treating this tumor, aiming to reduce local recurrence.
Keywords: dermatofibrosarcoma protuberans; Mohs micrographic surgery; recurrence rate; slow-Mohs dermatofibrosarcoma protuberans; Mohs micrographic surgery; recurrence rate; slow-Mohs

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MDPI and ACS Style

Shoufani, R.; Berl, A.; Shir-az, O.; Kidron, D.; Mann, D.; Castel, N.; Shalom, A. Overcoming Mohs Limitations in Treating DFSP: Retrospective Analysis of a Novel Excision Technique. Life 2025, 15, 1025. https://doi.org/10.3390/life15071025

AMA Style

Shoufani R, Berl A, Shir-az O, Kidron D, Mann D, Castel N, Shalom A. Overcoming Mohs Limitations in Treating DFSP: Retrospective Analysis of a Novel Excision Technique. Life. 2025; 15(7):1025. https://doi.org/10.3390/life15071025

Chicago/Turabian Style

Shoufani, Rami, Ariel Berl, Ofir Shir-az, Deborah Kidron, Din Mann, Noam Castel, and Avshalom Shalom. 2025. "Overcoming Mohs Limitations in Treating DFSP: Retrospective Analysis of a Novel Excision Technique" Life 15, no. 7: 1025. https://doi.org/10.3390/life15071025

APA Style

Shoufani, R., Berl, A., Shir-az, O., Kidron, D., Mann, D., Castel, N., & Shalom, A. (2025). Overcoming Mohs Limitations in Treating DFSP: Retrospective Analysis of a Novel Excision Technique. Life, 15(7), 1025. https://doi.org/10.3390/life15071025

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