{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:03:30Z","timestamp":1781103810721,"version":"3.54.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T00:00:00Z","timestamp":1628553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T00:00:00Z","timestamp":1628553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cancer"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dermatofibrosarcoma protuberans (DFSP) is a rare, low- to intermediate-grade sarcoma, which represents a diagnostic imaging challenge.<\/jats:p>\n                    <jats:p>This study aimed to analyze the clinical and ultrasound features of primary and recurrent DFSP to improve the diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical, imaging, and pathological data from a total of 58 patients (23 patients with primary DFSP and 35 patients with recurrent DFSP) were retrospectively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was no statistically significant difference in age, sex, tumor size, or echogenicity between the two groups. Most of the primary DFSP lesions involved the overlying dermis and hypodermis, while most of the recurrent DFSP lesions were fixated to more deeply seated structures at the original surgical incision. Red nodules on the skin were found more frequently in the primary group. There were statistically significant differences in the type of lesion and ultrasound tumor morphology (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.050). The lesions in the primary group showed more tentacle-like projections or a \u201cclaw\u201d sign, while the lesions in the recurrent group were more commonly oval, lobulated, and irregularly shaped. Hypervascularity was common in both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For primary DFSP, a slow-growing, red nodule on the skin involving the overlying dermis and hypodermis, more frequently a hypoechoic mass with tentacle-like projections or a \u201cclaw\u201d sign, was observed. For recurrent DFSP, palpable subcutaneous nodules or subcutaneous masses at the original surgical incision and oval, lobulated, and irregularly shaped lesions were more commonly observed. This may be useful for improving diagnostic accuracy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12885-021-08476-2","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T09:03:49Z","timestamp":1628586229000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Role of ultrasound in the diagnosis of primary and recurrent dermatofibrosarcoma protuberans"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1383-0452","authenticated-orcid":false,"given":"Min-Hong","family":"Zou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3142-4490","authenticated-orcid":false,"given":"Qing","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1259-5860","authenticated-orcid":false,"given":"Ye","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3941-8271","authenticated-orcid":false,"given":"Luan-jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5729-6082","authenticated-orcid":false,"given":"Yang","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7129-8436","authenticated-orcid":false,"given":"Rong-Qin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"key":"8476_CR1","unstructured":"Jeremic J, Stefanovic A, Jeremic K, Jovic M, Pilic I, Cvetkovic A, Stojanovic M. Giant dermatofibrosarcoma protuberans vulvae: rare clinical presentation and literature review. J Buon. 2019;24(3):1289-1295."},{"key":"8476_CR2","doi-asserted-by":"crossref","unstructured":"Serra-Guillen C, Sanmartin O, Llombart B, Nagore E, Deltoro C, Martin I, Borella-Estrada R, Requena C, Martorell-Calatayud A, Cervera J, et al. Correlation between preoperative magnetic resonance imaging and surgical margins with modified Mohs for dermatofibrosarcoma protuberans. Dermatol Surg. 2011;37(11):1638-45.","DOI":"10.1111\/j.1524-4725.2011.02077.x"},{"key":"8476_CR3","doi-asserted-by":"crossref","unstructured":"Zhang L, Liu QY, Cao Y, Zhong JS, Zhang WD. Dermatofibrosarcoma Protuberans: Computed Tomography and Magnetic Resonance Imaging Findings. Medicine (Baltimore). 2015;94(24):e1001.","DOI":"10.1097\/MD.0000000000001001"},{"key":"8476_CR4","doi-asserted-by":"crossref","unstructured":"Sedaghat S, Schmitz F, Sedaghat M, Nicolas V. Appearance of recurrent dermatofibrosarcoma protuberans in postoperative MRI follow-up. J Plast Reconstr Aesthet Surg. 2020;73(11):1960-5.","DOI":"10.1016\/j.bjps.2020.08.089"},{"key":"8476_CR5","doi-asserted-by":"crossref","unstructured":"Chung HW, Cho KH. Ultrasonography of soft tissue \"oops lesions\". Ultrasonography. 2015;34(3):217-25.","DOI":"10.14366\/usg.14068"},{"key":"8476_CR6","doi-asserted-by":"crossref","unstructured":"Giovagnorio F, Andreoli C, De Cicco ML. Color Doppler sonography of focal lesions of the skin and subcutaneous tissue. J Ultrasound Med. 1999;18(2):89-93.","DOI":"10.7863\/jum.1999.18.2.89"},{"key":"8476_CR7","doi-asserted-by":"crossref","unstructured":"Corvino A, Sandomenico F, Corvino F, Campanino MR, Verde F, Giurazza F, Tafuri D, Catalano O. Utility of a gel stand-off pad in the detection of Doppler signal on focal nodular lesions of the skin. J Ultrasound. 2020;23(1):45-53.","DOI":"10.1007\/s40477-019-00376-3"},{"key":"8476_CR8","doi-asserted-by":"crossref","unstructured":"Shin YR, Kim JY, Sung MS, Jung JH. Sonographic findings of dermatofibrosarcoma protuberans with pathologic correlation. J Ultrasound Med. 2008;27(2):269-74.","DOI":"10.7863\/jum.2008.27.2.269"},{"key":"8476_CR9","doi-asserted-by":"crossref","unstructured":"Ma C, Sun Y, Yang X, Zhang Q, Zhang C, Cui L. Improving precision of resection by pre-surgery inspections with contrast-enhanced ultrasound for dermatofibrosarcoma protuberans. Dermatol Ther. 2016;29(6):473-5.","DOI":"10.1111\/dth.12401"},{"key":"8476_CR10","doi-asserted-by":"crossref","unstructured":"Rodriguez BA, Moreno BG, Feito RM, Beato MM, de Lucas LR. Jellyfish-like sonographic pattern can help recognition of dermatofibrosarcoma protuberans. Report of 3 new cases and review of the literature. Australas J Dermatol. 2019;60(2):e148-e150.","DOI":"10.1111\/ajd.12922"},{"key":"8476_CR11","doi-asserted-by":"crossref","unstructured":"Bard RL. High-Frequency Ultrasound Examination in the Diagnosis of Skin Cancer. Dermatol Clin. 2017;35(4):505-11.","DOI":"10.1016\/j.det.2017.06.011"},{"key":"8476_CR12","doi-asserted-by":"crossref","unstructured":"Adler DD, Carson PL, Rubin JM, Quinn-Reid D. Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings. Ultrasound Med Biol. 1990;16(6):553-9.","DOI":"10.1016\/0301-5629(90)90020-D"},{"key":"8476_CR13","doi-asserted-by":"crossref","unstructured":"Pack GT, Tabah EJ. Dermato-fibrosarcoma protuberans. A report of 39 cases. AMA Arch Surg. 1951;62(3):391\u2013411.","DOI":"10.1001\/archsurg.1951.01250030397008"},{"key":"8476_CR14","unstructured":"Smola MG, Soyer HP, Scharnagl E. Surgical treatment of dermatofibrosarcoma protuberans. A retrospective study of 20 cases with review of literature. Eur J Surg Oncol. 1991;17(5):447\u201353."},{"key":"8476_CR15","doi-asserted-by":"crossref","unstructured":"Bianchini L, Maire G, Guillot B, Joujoux JM, Follana P, Simon MP, Coindre JM, Pedeutour F. Complex t(5;8) involving the CSPG2 and PTK2B genes in a case of dermatofibrosarcoma protuberans without the COL1A1-PDGFB fusion. Virchows Arch. 2008;452(6):689-96.","DOI":"10.1007\/s00428-008-0580-2"},{"key":"8476_CR16","doi-asserted-by":"crossref","unstructured":"Bogucki B, Neuhaus I, Hurst EA. Dermatofibrosarcoma protuberans: a review of the literature. Dermatol Surg. 2012;38(4):537-51.","DOI":"10.1111\/j.1524-4725.2011.02292.x"},{"key":"8476_CR17","doi-asserted-by":"crossref","unstructured":"Lyu A, Wang Q. Dermatofibrosarcoma protuberans: A clinical analysis. Oncol Lett. 2018;16(2):1855\u201362.","DOI":"10.3892\/ol.2018.8802"},{"key":"8476_CR18","doi-asserted-by":"crossref","unstructured":"Hao X, Billings SD, Wu F, Stultz TW, Procop GW, Mirkin G, Vidimos AT. Dermatofibrosarcoma Protuberans: update on the diagnosis and treatment. J Clin Med. 2020;9(6):1752.","DOI":"10.3390\/jcm9061752"},{"key":"8476_CR19","doi-asserted-by":"crossref","unstructured":"Hakozaki M, Yamada H, Hasegawa O, Watanabe K, Konno S. Radiologic-pathologic correlations of fibrosarcomatous dermatofibrosarcoma protuberans with various histological features on enhanced MRI and PET\/MRI. Clin Nucl Med. 2016;41(3):241\u20133.","DOI":"10.1097\/RLU.0000000000001099"},{"key":"8476_CR20","doi-asserted-by":"crossref","unstructured":"Kim HW, Yoo SY, Oh S, Jeon TY, Kim JH. Ultrasonography of pediatric superficial soft tissue tumors and tumor-like lesions. Korean J Radiol. 2020;21(3):341\u201355.","DOI":"10.3348\/kjr.2019.0343"},{"key":"8476_CR21","doi-asserted-by":"crossref","unstructured":"Dominguez-Malagon H, Valdez-Carrillo MC, Cano-Valdez AM. Dermatofibroma and dermatofibrosarcoma protuberans: a comparative ultrastructural study. Ultrastruct Pathol. 2006;30(4):283\u201391.","DOI":"10.1080\/01913120600820468"},{"key":"8476_CR22","doi-asserted-by":"crossref","unstructured":"Kohlmeyer J, Steimle-Grauer SA, Hein R. Kutane Sarkome. J Dtsch Dermatol Ges. 2017;15(6):630\u201349.","DOI":"10.1111\/ddg.13249_g"},{"key":"8476_CR23","doi-asserted-by":"crossref","unstructured":"Sung TH, Tam AC, Khoo JL. Dermatofibrosarcoma protuberans: a comprehensive review on the spectrum of clinico-radiological presentations. J Med Imaging Radiat Oncol. 2017;61(1):9\u201317.","DOI":"10.1111\/1754-9485.12549"},{"key":"8476_CR24","doi-asserted-by":"crossref","unstructured":"Shi X, Tan Q. Clinical and pathological analysis of dermatofibrosarcoma protuberans with long-term follow-up. J Plast Reconstr Aesthet Surg. 2020;73(6):1143\u201350.","DOI":"10.1016\/j.bjps.2020.02.012"},{"key":"8476_CR25","doi-asserted-by":"crossref","unstructured":"Zhou X, Sun D, Liu Y, Sun Q, Yuan Z, Luo X, Yang J, Chen J. Dermatofibrosarcoma protuberans: our 10-year experience on 80 patients. J Dermatolog Treat. 2020;31(6):554\u20138.","DOI":"10.1080\/09546634.2019.1622629"},{"key":"8476_CR26","doi-asserted-by":"publisher","unstructured":"Lowe GC, Onajin O, Baum CL, Otley CC, Arpey CJ, Roenigk RK, Brewer JD. A comparison of Mohs micrographic surgery and wide local excision for treatment of dermatofibrosarcoma protuberans with long-term follow-up: the Mayo clinic experience. Dermatol Surg. 2017;43(1):98\u2013106. https:\/\/doi.org\/10.1097\/DSS.0000000000000910.","DOI":"10.1097\/DSS.0000000000000910"},{"key":"8476_CR27","doi-asserted-by":"crossref","unstructured":"Won KY, Park SY, Jin W, Lew BL. Dermatofibroma: sonographic findings and pathologic correlation. Acta Radiol. 2018;59(4):454\u20139.","DOI":"10.1177\/0284185117721263"}],"container-title":["BMC Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-021-08476-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12885-021-08476-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-021-08476-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T09:04:42Z","timestamp":1628586282000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccancer.biomedcentral.com\/articles\/10.1186\/s12885-021-08476-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,10]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["8476"],"URL":"https:\/\/doi.org\/10.1186\/s12885-021-08476-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-454083\/v1","asserted-by":"object"}]},"ISSN":["1471-2407"],"issn-type":[{"value":"1471-2407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,10]]},"assertion":[{"value":"23 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of the Third Affiliated Hospital, Sun Yat-Sen University in accordance with the Declaration of Helsinki. Written informed consent was obtained from all patients or patients\u2019 parents\/guardians for use of their clinical data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"M.H.Z. informed the patients that their clinical and personal details would be published in a journal, and written informed consent for publication was obtained from the patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"909"}}