Hyalinized collagen in a dermatofibrosarcoma protuberans after treatment with imatinib mesylate

J Cutan Pathol. 2008 Nov;35(11):1003-6. doi: 10.1111/j.1600-0560.2007.00948.x. Epub 2008 Jun 9.

Abstract

We report a novel histological finding in a dermatofibrosarcoma protuberans (DFSP) after treatment with imatinib mesylate: copious amounts of hyalinized collagen. A 57-year-old female was referred for evaluation and treatment of a 7 x 8 x 10 cm tumor on the right anterior shoulder. Histological evaluation of the incisional biopsy showed a highly cellular dermal neoplasm composed of spindle cells arranged in a storiform pattern with minimal collagen. A CD34 immunohistochemical stain was strongly positive, highlighting atypical spindle cells in the dermis. A diagnosis of DFSP was made and the patient was enrolled in the Southwest Oncology Group trial. She received imatinib mesylate 400 mg per day for 1 year. At the end of therapy, the DFSP decreased in size to 5.5 x 4 x 4 cm. The tumor was excised. Histological evaluation showed a residual dermal neoplasm composed of atypical spindle cells and a copious amount of hyalinized collagen. Areas of necrosis were not seen. A CD34 stain confirmed the presence of residual DFSP, highlighting atypical spindle cells. A procollagen I stain was strongly positive, confirming the presence of abundant collagen in the dermis. A similar finding has been reported in gastrointestinal stromal tumor, which shows deposition of myxohyaline stroma after treatment with imatinib mesylate.

Publication types

  • Case Reports

MeSH terms

  • Antigens, CD34 / metabolism
  • Antineoplastic Agents / therapeutic use*
  • Benzamides
  • Biomarkers, Tumor / metabolism
  • Collagen / metabolism*
  • Combined Modality Therapy
  • Dermatofibrosarcoma / drug therapy*
  • Dermatofibrosarcoma / metabolism
  • Dermatofibrosarcoma / pathology
  • Female
  • Humans
  • Hyalin / metabolism*
  • Imatinib Mesylate
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Middle Aged
  • Piperazines / therapeutic use*
  • Pyrimidines / therapeutic use*
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / metabolism
  • Skin Neoplasms / pathology

Substances

  • Antigens, CD34
  • Antineoplastic Agents
  • Benzamides
  • Biomarkers, Tumor
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate
  • Collagen