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Abstract
A 58 year old female presented with swelling over the upper abdomen for 8 months. The patient was apparently alright 8 months ago when she noticed a painless swelling,approximately the size of a lemon, which gradually progressed to the present size. There was no history of trauma, fever, discharge or bleeding from the swelling. There was no history of change in size of the swelling on exertion or straining. There were no aggravating or relieving factors. On examination, a solitary swelling of approximate size 5×3 cm was noted over the epigastric region. Skin over the swelling was smooth, shiny, and tense with surrounding erythema. There was no discharge from the swelling. The swelling was ill defined with irregular border. A healed ulcer of 1 cm was noted over the summit of the swelling. Inspectory findings were confirmed by palpation. The swelling was non tender .There was no local rise of temperature. The swelling was firm in consistency, non compressible and immobile. Skin was not pinchable.It did not change in size on valsalva manoeuvre.
An ultrasound examination of the abdomen was performed, which was suggestive of slow flow AV malformation. Hence, a CT angiogram was performed which showed a lobulated,isodense lesion measuring 5.6x3 cm in the epigastric region.On post contrast study the lesion showed homogeneous enhancement with superior epigastric artery as the feeding artery.
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References
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References
Criscione VD, Weinstock MA. Descriptive epidemiology of dermatofibrosarcoma protuberans in the United States, 1973–2002. J Am Acad Dermatol 2007;56(6):968-73.
Lemm D, Mügge LO, Mentzel T, et al. Current treatment options in dermatofibrosarcoma protuberans. J Cancer Res Clin Oncol 2009;135(5):653-65.
Simon MP, Pedeutour F, Sirvent N, et al. Deregulation of the platelet-derived growth factor B-chain gene via fusion with collagen gene COL1A1 in dermatofibrosarcoma protuberans. Nat Genet 1997;15(1):95-8.
McArthur GA. Molecularly targeted treatment for dermatofibrosarcoma protuberans. Semin Oncol 2007;34(2 Suppl 1):S26-30.
Rutkowski P, Van Glabbeke M, Rankin CJ, et al. Imatinib mesylate in advanced dermatofibrosarcoma protuberans: pooled analysis of two phase II clinical trials. Eur J Cancer 2010;46(16):3063-70.
Weiss SW, Goldblum JR. Enzinger and Weiss's soft tissue tumors. 6th edn. Philadelphia: Elsevier 2014.