Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar

Abstract Background Dermatofibrosarcoma protuberans (DFSP) has a high recurrence rate after resection. Because of the lack of specific manifestations, recurrent DFSP is easily misdiagnosed as post-resection scar. A few series have reported ultrasound findings of recurrent DFSP; moreover, the usefuln...

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Main Authors: Xia Gong, Jia Li, Angang Ding, Jiaxin Zuo, Yamin Rao, Jun Chen, Ping Xiong
Format: Article
Language:English
Published: BMC 2024-03-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-024-11991-7
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author Xia Gong
Jia Li
Angang Ding
Jiaxin Zuo
Yamin Rao
Jun Chen
Ping Xiong
author_facet Xia Gong
Jia Li
Angang Ding
Jiaxin Zuo
Yamin Rao
Jun Chen
Ping Xiong
author_sort Xia Gong
collection DOAJ
description Abstract Background Dermatofibrosarcoma protuberans (DFSP) has a high recurrence rate after resection. Because of the lack of specific manifestations, recurrent DFSP is easily misdiagnosed as post-resection scar. A few series have reported ultrasound findings of recurrent DFSP; moreover, the usefulness of contrast-enhanced ultrasound in differentiating recurrent DFSP has not been studied. Objective We investigated conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent DFSP and post-resection scar. Methods We retrospectively evaluated the findings of conventional and contrast-enhanced ultrasound in 34 cases of recurrent DFSP and 38 postoperative scars examined between January 2018 and December 2022. Results The depth and vascular density of recurrent DFSP were greater than those of postoperative scars (P < 0.05). On gray-scale ultrasound, recurrent DFSP lesions were more commonly irregular, heterogeneous, and hypoechoic, with finger-like projections and ill-defined borders. Postoperative scar was more likely to appear as hypoechoic and homogeneous with well-defined borders (P < 0.05). On color Doppler ultrasound, recurrent DFSP was more likely to feature rich arterial and venous blood flow, and postoperative scar was more likely to display poor blood flow (P < 0.05). On contrast-enhanced ultrasound, recurrent DFSP was more likely to feature heterogeneous hyper-enhancement, and postoperative scar was more likely to display homogeneous iso-enhancement (P < 0.05). Recurrent DFSP presented a higher peak and sharpness than postoperative scar (P < 0.05). Conclusion Conventional and contrast-enhanced ultrasound produced distinct features of recurrent DFSP and post-resection scar, which could improve the accuracy of differential diagnosis.
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spelling doaj.art-bc481564b05b48008ccfa096c6464eec2024-03-05T19:23:32ZengBMCBMC Cancer1471-24072024-03-012411810.1186/s12885-024-11991-7Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scarXia Gong0Jia Li1Angang Ding2Jiaxin Zuo3Yamin Rao4Jun Chen5Ping Xiong6Department of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Pathology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Dermatology and Dermatologic Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityAbstract Background Dermatofibrosarcoma protuberans (DFSP) has a high recurrence rate after resection. Because of the lack of specific manifestations, recurrent DFSP is easily misdiagnosed as post-resection scar. A few series have reported ultrasound findings of recurrent DFSP; moreover, the usefulness of contrast-enhanced ultrasound in differentiating recurrent DFSP has not been studied. Objective We investigated conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent DFSP and post-resection scar. Methods We retrospectively evaluated the findings of conventional and contrast-enhanced ultrasound in 34 cases of recurrent DFSP and 38 postoperative scars examined between January 2018 and December 2022. Results The depth and vascular density of recurrent DFSP were greater than those of postoperative scars (P < 0.05). On gray-scale ultrasound, recurrent DFSP lesions were more commonly irregular, heterogeneous, and hypoechoic, with finger-like projections and ill-defined borders. Postoperative scar was more likely to appear as hypoechoic and homogeneous with well-defined borders (P < 0.05). On color Doppler ultrasound, recurrent DFSP was more likely to feature rich arterial and venous blood flow, and postoperative scar was more likely to display poor blood flow (P < 0.05). On contrast-enhanced ultrasound, recurrent DFSP was more likely to feature heterogeneous hyper-enhancement, and postoperative scar was more likely to display homogeneous iso-enhancement (P < 0.05). Recurrent DFSP presented a higher peak and sharpness than postoperative scar (P < 0.05). Conclusion Conventional and contrast-enhanced ultrasound produced distinct features of recurrent DFSP and post-resection scar, which could improve the accuracy of differential diagnosis.https://doi.org/10.1186/s12885-024-11991-7Contrast-enhanced ultrasoundConventional ultrasoundColor DopplerPostoperative scarRecurrent dermatofibrosarcoma protuberans
spellingShingle Xia Gong
Jia Li
Angang Ding
Jiaxin Zuo
Yamin Rao
Jun Chen
Ping Xiong
Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar
BMC Cancer
Contrast-enhanced ultrasound
Conventional ultrasound
Color Doppler
Postoperative scar
Recurrent dermatofibrosarcoma protuberans
title Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar
title_full Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar
title_fullStr Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar
title_full_unstemmed Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar
title_short Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar
title_sort conventional and contrast enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar
topic Contrast-enhanced ultrasound
Conventional ultrasound
Color Doppler
Postoperative scar
Recurrent dermatofibrosarcoma protuberans
url https://doi.org/10.1186/s12885-024-11991-7
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