Tumor Surgery : Bone Cancer Tumors : Sarcoma Surgeon : NYC

Dermatofibrosarcoma Protuberans (DFSP) is an infrequent type of malignant skin sarcoma. It arises from the dermis of the skin. DFSP accounts for less than 6% of all soft tissue sarcomas. There are approximately 1000 cases in the United States yearly (3 cases per million yearly). This type of tumor most commonly affects patients between 20 and 50 years old. The most common location for DFSP is around the torso (50%), but is also seen on the legs, arms, neck and head.

Dermatofibrosarcoma Protuberans grows slowly and starts as a flatness or depression in the skin. Commonly is described as a reddish or purplish patch in the skin. Although this tumor is located in the skin DFSP tends to grow deeply into the surrounding fat, muscle and rarely bone.

PATHOLOGY

Histologically it is described as a highly cellular low grader spindle cell tumor with storiform and honeycomb pattern. There are multiple spindled cells with scant cytoplasm and hyperchromatic nuclei in a very symmetric distribution (fig B5 & B6).

RADIOLOGY

Magnetic Resonance Image (MRI) is the most sensitive and specific radiographic study for DFSP. In most instances the MRI appearance is non specific and other types of sarcomas and other conditions can have a similar appearance. This type of tumor demonstrates on MRI low signal on T1-weighted (Fig B1) and equal or similar signal intensity as the adjacent subcutaneous fat on T2-weighted images (Fig A1 & A2). It shows suppression on fat saturation sequences and enhances (Fig A3 & A4) on contrast enhanced sequences.

TREATMENT

The mainstay therapy for DFSP is the wide resection of the tumor (Fig B8 – B12). It has a tendency to recur in the same location after it is removed.

PROGNOSIS

Metastases are present in about 5% of cases. In most cases DFSP are low grade tumors and rarely metastasize. Tumors that are large and have been growing for a prolonged period of time can turn high grade and/or dedifferentiate which is associated with a poor prognosis. The most common site for metastases is the lungs however high grade variants may have a strange pattern of metastases.

Office Locations

Morristown Medical Center

Carol G. Simon Cancer Center

100 Madison Avenue

2nd Floor

Morristown, NJ 07960

Phone: 833-292-BONE (2663)
Fax: 973-898-1636
Email: drjameswittig@gmail.com

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Services & Specialties

Pediatric and Adult Bone Sarcomas
Soft Tissue Sarcomas
Benign Bone Tumors
Benign Soft Tissue Tumors
Childhood Sarcomas
Shoulder Tumors
Cryosurgery
Radiofrequency Ablation
Special Surgeries
Diagnosis and Treatment

Testimonials

"Thank you from the bottom of my heart for your excellent care...I wish you a very long and productive professional life so that more people can benefit from your expertise, so that more people can get a second chance to live their lives to the fullest."

Irina B.

"I am writing to you to thank you for everything you and your team have done for me. I cannot tell you how fortunate I feel that I am in your care. It gives me the peace of mind that I have you as my doctor. Your knowledge and expertise is greatly appreciated. You truly are the best! Thank you!"

-Sincerely,
JG

Dear Dr. Wittig,
I am writing at a loss to find adequate words to thank you for all that you have done for me. You were so generous to give up your time on a weekend to operate on my femur. I believe that this made a vast difference in my life. Your skills as a diagnostician and surgeon have given me an opportunity to have a better life. At a time like this, it is comforting to be treated with kindness and skill. Thank you for sharing your gifts with me.

Dear Dr. Wittig,
I'm so thrilled with your diagnosis, and thankful too! If you're ever in S. Orange and would like to visit "The Gate" for a pint, I'd be happy to personally escort you. You'll get the VIP treatment. Thank you so very much for your attention and professionalism.

Dear Dr. Wittig,
I can't thank you, and your team enough for making our son, who recently underwent surgery (removing a tumor on his pelvis), feel so comfortable and at ease. As did you, with my family, addressing all our questions, and concerns. We knew he as in the best possible hands. You are a wonderful, compassionate Doctor....We are so grateful to have such a gifted Dr. taking care of him.
Sincerely,
Sandy

Dear Dr. Wittig,

Thank-you so very much for being my surgeon for that chondrosarcoma, for saving my life! And I have learned over the months (from other doctors...) that I was very fortunate to have you as a surgeon.

I think that I should have been more cheerful and clear upon receiving the good news from you during the visit on Wednesday.--I was just that I've been so anxious, worried, tense, confused from 6 months of various treatments -- prostate 45 day radiation, gall stone passing, kidney stone matters that have been happening these past months.

In driving home after the news today, I've begun feeling increasingly released, cheerful...able at long last to get on fully with my life.

You, your staff, that hospital...have set the bar for health care so much higher than I could have imagined.

With Deepest Gratitude!

Robert

Good evening Dr. Wittig,

I hope you are doing well this evening and hope you have a restful weekend with your family. It was a pleasure meeting you in person. After meeting you, I can understand why you and Sheeraz are close friends and colleagues, especially how highly Sheeraz spoke of you! You are kind and down to earth. Also, you and Sheeraz are not only amazing and talented doctors, but you are compassionate and empathetic to the needs of your patients and families, which often lacks in the world of medicine. I wanted to be a doctor, but I really can't deal with the sight of blood, like I mentioned to Sheeraz. Both of you are great role models how family centered care should be and how I strive and want to be with my little patients at Sloan.

I appreciate everything you have done for my Uncle. I am grateful to Sheeraz for recommending you! I hope you and your family are always happy and healthy, so you can continue to great things to impact the quality of life of others...

Thanks so much again for everything NYU familia!

Kind Regards,
Mariyam

On May 10th I had the pleasure of meeting Dr. Wittig for the first time. This was an extremely stressful time for me since I had received several reports regarding my cancer diagnosis. Upon meeting Dr, Wittig I immediately knew I was in good hands. His calm demeanor & straightforward manner were very comforting to me. He laid out how he was going to proceed with the operation, how long it would take, & followup. He has been a source of comfort to me thru out this ordeal & I know I could not be in a better place with him. His support staff of nurses, is top notch. Their attention to detail, answering questions we may have, are always done in a timely manner. Without the ease of working with Dr. James Wittig, I can tell you. I would not feel as confident with my situation as I do. He is truly a very special human being. Sincerely, Karolyn

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