Dermatofibrosarcoma protuberans (DFSP) is an unusual spindle cell tumor with a high rate of local recurrence with traditional\nexcision. Fortunately,Mohs micrographic surgery yields excellent cure rates for this neoplasm due to contiguous tumor spread and\nmeticulous tumor mapping and margin analysis.We present the unique case of a patient treated with a modified Mohs technique\nwith an analysis of the final margin with permanent sections, who developed a spindle cell neoplasm in the margins of her second\nstage excision consistent with nodular fasciitis. Distinguishing residual DFSP from a benign reactive process was an essential and\nchallenging component of this patient�s management.
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