Sažetak
Uvod. Dermatofibrosarkom protuberans (DFSP) je veoma redak mezenhimalni tumor koji čini otprilike 0,1% svih maligniteta. To je lokalno agresivni fibrozni tumor, sa velikom stopom recidiva, koji ponekad može dati udaljene metastaze, obično u kostima i plućima. DFSP se obično javlja na trupu i ekstremitetima, a samo kod malog broja obolelih u dojci, posebno kod muškaraca. Prikaz bolesnika. Prikazan je redak slučaj DFSP u levoj dojci 66-godišnjeg muškarca koji se manifestovao kao ginekomastija. Dijagnostička obrada obuhvatila je klinički pregled, ultrazvučni pregled, “core” biopsiju i mamografiju. Imunohistohemija je pokazala difuznu i jaku pozitivnost za vimentin, CD99 i CD34, dok su tumorske ćelije bile potpuno negativne na keratin, S100 protein, STAT6, CD31 i faktor VIII, što je sugerisalo da se radi o DFSP. Nakon toga, izvršena je radikalna mastektomija i pregledom patologa i imunohistohemijskim metodama potvrđena je preoperativna dijagnoza DFSP. Bolesnik je šest meseci posle hirurškog lečenja i dalje bio bez bolesti. Zaključak. DFSP je sarkom mekog tkiva koji se izuzetno retko razvija u dojkama muškaraca. Uobičajena klinička prezentacija na dojci jeste masa sa širokim krvžicama na površini, mada se može prezentovati i samo kao ginekomastija, kao u opisanom slučaju. Dijagnoza DFPS se zasniva na patoanatomskoj i imunohistohemijskoj analizi jer ne postoje specifični znaci za ovaj retki entitet, vidljivi primenom različitih tehnika snimanja. Hirurška ekscizija sa širokim i negativnim marginama je optimalna za smanjenje rizika od recidiva.
Ključne reči
dermatofibrosarkom; dijagnoza, diferencijalna
imunohistohemija
bolesti, retke
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