title: Half forehead reconstruction with a single rotational scalp flap for dermatofibrosarcoma protuberans treatment.
abstract: BACKGROUND
  Dermatofibrosarcoma protuberans (DFSP) is a soft tissue neoplasm of intermediate to low-grade malignancy. Although metastasis rarely occurs, DFSP has a locally aggressive behavior with a high recurrence rate. In the head and neck area, resection involving a wide margin of healthy tissue can be difficult because of functional and cosmetic considerations. We describe a novel reconstructive method for half forehead defects with an innovative single local wide scalp flap following excision of DFSP with a 3 cm margin of healthy tissue.
  
  
  METHODS
  Two patients underwent wide resection of forehead DFSP and reconstruction with a single rotational scalp flap. The scalp flap blood supply was provided from three main vessels: the superficial temporal artery, occipital artery and posterior auricular artery.
  
  
  RESULTS
  No early or late complications were observed in either patient with no local recurrence after 18 months of follow-up. The donor area could be closed primarily in both cases and the flaps survived completely.
  
  
  CONCLUSIONS
  This innovative technique allowed a radical excision of forehead DFSP with sufficient healthy margins, thus potentially decreasing tumor recurrence rate. Reconstruction was achieved avoiding microsurgery, skin expanders and large skin grafts. Moreover, all main reconstructive criteria, such as functional and cosmetic tissue characteristics, were completely fulfilled.
authors.affiliation: Department of Surgery "Melanoma - Soft Tissues - Head & Neck - Skin Cancers", National Cancer Institute, Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Mori
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Monta
authors.forename: Ugo
authors.initials: U
authors.lastname: Marone
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Chiofalo
authors.forename: Corrado
authors.initials: C
authors.lastname: Caracò
mesh_terms: D018223:Dermatofibrosarcoma / Q000601:surgery*; D005546:Forehead / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000637:transplantation*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D013524:Surgical Flaps / Q000637:transplantation*