title: Dermatofibrosarcoma protuberans of the forehead and scalp with involvement of the outer calvarial plate: multistaged repair with the use of skin expanders.
abstract: OBJECTIVE
  Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive and infiltrative tumor that requires Mohs' micrographic surgery or wide excision to treat. Adequate excision often leaves a cosmetic disfiguring defect, particularly if the tumor is located on the head and neck. Complex defects of the face present special problems, such as distortion, ectropion, and retraction of normal tissues.
  
  
  METHODS
  We present a case of an infiltrating DFSP of the forehead and scalp in a young woman. The tumor was removed, and the defect was reconstructed with multistaged repair, which included bone coverage, local and regional flaps, and the use of expanders.
  
  
  RESULTS
  A multistaged repair was performed with good clinical outcome and satisfactory cosmetic results.
  
  
  CONCLUSIONS
  Multistaged repair of the face is a viable alternative surgical approach to preserve facial contours and minimize distortion in the treatment of DFSP. This case illustrates the degree of complexity that the treatment of DFSP may involve.
authors.affiliation: Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. amorkh@pol.net
authors.forename: Amor
authors.initials: A
authors.lastname: Khachemoune
authors.forename: David
authors.initials: D
authors.lastname: Barkoe
authors.forename: Martin
authors.initials: M
authors.lastname: Braun
authors.forename: Steven P
authors.initials: SP
authors.lastname: Davison
mesh_terms: D000328:Adult; D018223:Dermatofibrosarcoma / Q000601:surgery*; D005260:Female; D005546:Forehead; D006801:Humans; D015580:Mohs Surgery; D012535:Scalp; D012878:Skin Neoplasms / Q000601:surgery*; D015625:Tissue Expansion Devices; D014945:Wound Healing / Q000502:physiology