History:

Patient of Dr 

Male early 40's presented september 2014 with lesion over left scapula. No history of trauma. I thought it may be keloid but no history of prior surgery.No clear history of change I sent him to one of the local plastic surgeons for opinion. Surgeon also thought was benign and was advised to watch and wait.No biopsy done.
The patient then returned in October 2015 with lesion as per photos. Re referred urgently to same specialist. Lesion was biopsied, dx = dermatofibrosarcoma protuberans. He went on to have wide excision down to fascia with a tri rhomboid flap procedure.