Pulmonary metastases of fibrosarcomatous dermatofibrosarcoma protuberans respond to apatinib-based angiogenesis and chemotherapy: a case report

Dermatofibrosarcoma protuberans (DFSP) is a rare and locally aggressive tumor arising from fibroblasts in subcutaneous mesenchymal tissue of the skin, commonly occurring in the extremities and trunk (1,2). DFSP is divided into various different subtypes. The fibrosarcomatous variant of DFSP (FS-DFSP) is a variant of DFSP and is diagnosed when more than 5% of fibrosarcomatous changes in the area are observed in typical DFSP (2). The incidence of FS-DFSP remains about 13% to 16% of DFSP (3). FS-DFSP has a higher risk of local recurrence, metastasis, and death from the disease than classical DFSP, usually with a poor outcome (2,4). Surgery and adjuvant radiotherapy are major therapeutic strategies for resectable DFSP. However, multidisciplinary consultation including chemotherapy, radiotherapy, target therapy, and anti-angiogenesis therapy is needed for metastatic diseases.