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Case Reports
. 2018 Jun 15;2018(6):rjy089.
doi: 10.1093/jscr/rjy089. eCollection 2018 Jun.

Management of dermatofibrosarcoma protuberans of the face using lower trapezius musculocutaneous pedicle flap reconstruction: a case report

Wahid Terro  1   2   3 , Nizar Hamadeh  4 , Miray Terro  5
Affiliations
Case Reports

Management of dermatofibrosarcoma protuberans of the face using lower trapezius musculocutaneous pedicle flap reconstruction: a case report

Wahid Terro et al. J Surg Case Rep. .

Abstract

Dermatofibrosarcoma protuberans (DFSP) is a rare neoplasm which represents <0.1% of all tumors but it is considered the most common skin sarcoma. It is a slow-growing tumor that arises from the dermis and invades deeper tissues. The precise origin of DFSP is not well known. It is most frequently seen on the trunk, extremities, and head and neck. The standard treatment of the localized huge DFSP consists of a wide local surgical resection with recommended surgical margins of 2-3 cm. Local recurrence after incomplete excision is common. We present a case of 35-year-old man with enormous bulky mass on the face. Upon histological examination, the diagnosis of DFSP was made, and the patient underwent en bloc wide local excision of the mass followed by the use of Trapezius musculocutaneous pedicle flap reconstruction. On 32 months follow-up, no recurrence has been reported.

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Figures

Figure 1:
Figure 1:
(A and B) A large protuberant mass located at the left side of the face of a 30-year-old Syrian refugee with skin laceration at the middle of the lesion.
Figure 2:
Figure 2:
En bloc excision. Macroscopic appearance of the surgical specimen is that of a large tumor (10 × 8 × 4 cm3). (A) From outside view. (B) From inside view.
Figure 3:
Figure 3:
(A) Postoperative defect in the left cheek region. Bone exposure is well noticed. (B) The surgical field with a wound dress (16 June 2015).
Figure 4:
Figure 4:
(A) Marking of the LTMC pedicle flap planning on the back. (B) Elevated flap as a distant pedicle flap. (30 June 2015).
Figure 5:
Figure 5:
The LTMC pedicle flap was completely covered the postsurgical defect (30 June 2015).
Figure 6:
Figure 6:
Postoperative view of the well healed LTMC distant pedicle flap. Note the slightly depressed of the left lower eyelid (12 August 2015).
Figure 7:
Figure 7:
Completely healed state of the donor site with secondary intention for 2 months.
See this image and copyright information in PMC

References

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