A case of recurrent dermatofibrosarcoma protuberans treated by mohs micrographic surgery using rush permanent sections

Dermatofibrosarcoma protuberans is a dermal spindle cell neoplasm of intermediate malignancy, and is characterized by a high local recurrence rate after surgical excision due to its aggressive, finger-like outgrowth pattern. Mohs micrographic surgery, which ensures complete excision of the tumor and minimizes normal tissue loss, is accepted as the treatment of choice for dermatofibrosarcoma protuberans. However, the use of frozen sections for margin control in dermatofibrosarcoma protuberans is controversial because it could be difficult to differentiate minimal residual tumor from normal skin on the frozen sections, and is more challenging in recurrent disease because of the scar tissue. We report a case of a recurrent dermatofibrosarcoma protuberans in which the tumor was excised using the Mohs surgical technique and margin control was achieved with horizontally-cut paraffin-embedded permanent sections, named as rush permanent sections.