Wide excision and anterolateral thigh perforator flap reconstruction for dermatofibrosarcoma protuberans of the face.
Dermatofibrosarcoma protuberans is a rare cutaneous malignant tumor associated with a high cure rate but with a high incidence of local recurrence. Because of its tentacle-like subcutaneous infiltrating pattern that extends far beyond the clinically visible skin lesion, a wide resection margin is recommended. Hence, its localization to the head-and-neck regions, although rare, represents a real challenge for both the oncologic surgeon and the reconstructive surgeon, who aim to achieve a radical resection of the tumor with the best possible aesthetic outcome.A case of a 21-year-old Mediterranean man who presented with a 7-month history of a slowly growing subcutaneous lesion of the left preauricular region is reported. A diagnosis of dermatofibrosarcoma protuberans CD34+ was confirmed through surgical biopsy, and the patient subsequently underwent a wide en bloc local surgical resection, followed by anterolateral thigh perforator free flap reconstruction. Healing was uneventful. Initially, there was some facial nerve neurapraxia; however, this completely subsided within 3 months after the surgery. At the 13-month follow-up, the patient was completely well and free from the disease.
From the *Plastic Surgery Unit, and †Maxillofacial Surgery Unit, Department of Neuroscienze, Salute Mentale e Organi di Senso, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Benedetto
B
Longo
Guido
G
Paolini
Evaristo
E
Belli
Brando
B
Costantino
Marco
M
Pagnoni
Fabio
F
Santanelli
D000714:Anastomosis, Surgical / Q000379:methods; D018223:Dermatofibrosarcoma / Q000601:surgery*; D005153:Facial Neoplasms / Q000601:surgery*; D005154:Facial Nerve / Q000503:physiopathology; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D061525:Perforator Flap / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D013848:Thigh / Q000601:surgery; D060053:Transplant Donor Site / Q000601:surgery; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult