{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:36:47Z","timestamp":1784255807723,"version":"3.55.0"},"reference-count":14,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,7,22]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>Dermatofibrosarcoma protuberans (DFSP) is an aggressive tumour with multiple local recurrences and rare metastatic potential. Fibrosarcomatous transformation occurs in a few cases of DFSP which makes them more aggressive in terms of recurrence and metastasis. Here we report the case of a woman in her late 30s who presented with massive lower gastrointestinal (GI) bleeding with a history of multiple surgeries for DFSP on her anterior abdominal wall. The bleeding source was identified to be a mass lesion in the jejunum, which was excised. The patient recovered well and the histopathology revealed fibrosarcoma of the jejunum. Follow-up investigations showed multiple lung nodules, ascites and abdominal lymph nodes suggesting progressive disease. She is currently receiving chemotherapy and progressing well 3 months postoperatively. Patients with fibrosarcomatous changes within DFSP must be followed up closely as it is associated with increased metastatic potential.<\/jats:p>","DOI":"10.1136\/bcr-2023-258875","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T22:40:26Z","timestamp":1722379226000},"page":"e258875","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Metastatic presentation of dermatofibrosarcoma protuberans as massive lower gastrointestinal bleed"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0087-5105","authenticated-orcid":false,"given":"Basil","family":"Babu","sequence":"first","affiliation":[{"name":"Department of General Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divij","family":"Jayant","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunanshu","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Kothari","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"2025082722403515000_17.7.e258875.1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.019349"},{"key":"2025082722403515000_17.7.e258875.2","doi-asserted-by":"crossref","first-page":"3171","DOI":"10.18203\/2349-2902.isj20214018","article-title":"Rare giant dermatofibrosarcoma protuberans with uncommon fibrosarcomatous transformation - case report and review of literature","volume":"8","author":"Aggarwal","year":"2021","journal-title":"Int Surg J"},{"key":"2025082722403515000_17.7.e258875.3","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.jdcr.2020.07.053","article-title":"Dermatofibrosarcoma protuberans with fibrosarcomatous transformation: a tale of unbridled expansion","volume":"6","author":"Reid","year":"2020","journal-title":"JAAD Case Rep"},{"key":"2025082722403515000_17.7.e258875.4","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s10195-016-0415-x","article-title":"Risk factors for distant metastasis of dermatofibrosarcoma protuberans","volume":"17","author":"Hayakawa","year":"2016","journal-title":"J Orthopaed Traumatol"},{"key":"2025082722403515000_17.7.e258875.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2003.12.005"},{"key":"2025082722403515000_17.7.e258875.6","unstructured":"Jka J . 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