Dermatofibrosarcoma protruberans of the scalp treated with customised surface mould high-dose-rate (HDR) brachytherapy: a case report

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft tissue tumor commonly occurring in the trunk or extremities, lesser than 5% being located on the scalp. Surgery is the mainstay of management of this locally infiltrative cutaneous soft tissue sarcoma, with a high probability of recurrence if margin remains positive or inadequate. Adjuvant radiotherapy to a dose of 40–60 Gy decreases this chance of recurrence considerably. Radiotherapy is generally delivered by interstitial HDR brachytherapy, opposed photon or electron beam. We report a case of a 24 year old female, presenting with a small, painless nodule over right frontal area of scalp, diagnosed as DFSP post surgery with close margin that was treated with adjuvant radiation customized HDR surface mould brachytherapy with good local control and cosmesis.