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. 2020 Jul 27;12(7):e9423.
doi: 10.7759/cureus.9423.

Resection and Reconstructive Options in the Management of Dermatofibrosarcoma Protuberans of the Head and Neck

Aqsa Akhtar  1 , Adeela Hussain Khan  2 , Mamoon Rashid  1 , Farhan Eitezaz  1 , Haroon Ur Rashid  1
Affiliations

Resection and Reconstructive Options in the Management of Dermatofibrosarcoma Protuberans of the Head and Neck

Aqsa Akhtar et al. Cureus. .

Abstract

Objective To discuss resection and various reconstructive options in patients with dermatofibrosarcoma protuberans (DFSP). Methods This study was conducted at Shifa International Hospital, Islamabad, Pakistan, from May 2018 to December 2019. All patients aged 20 years or above of either gender who were diagnosed to have DFSP over this period were included in the study. All the patients underwent wide local excision of the tumor under general anesthesia. A peroperative frozen section was conducted in all the cases to confirm complete excision. Immediate reconstruction was performed following the tumor excision. The choice of reconstruction, i.e. free, regional, or local flap was based on the size of the resultant defect. Results The mean age of the patients was 37.11 ±10.91 years. There were 12 (66.7%) males and six (33.3%) females. The mean duration of the disease was 11.22 ±2.94 months. The affected anatomical site showed that the face was involved in the majority, nine (50%) patients, followed by the scalp in four (22.2%), nape of the neck in three (16.7%), and supraclavicular region in two (11.1%) patients. In most of the cases, the free flap was observed, i.e. (n=9, 50%), followed by a regional flap in seven (38.9%), and the local flap in two (10.1%) patients. Conclusion Wide local excision of the disease, confirmed on frozen section, offers improved survival. Among DFSP of the head and neck, the face was found to be the affected anatomical site in half the cases. Also, reconstruction following tumor excision with a free flap is the most favorable option among patients with DFSP.

Keywords: dfsp; free flaps; head and neck; reconstruction; sarcoma; shifa international hospital; wide local excision.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. A: Long-standing DFSP of the cheek, involving the underlying buccal mucosa. B: Resection specimen with the defect. C: Reconstruction using the radial forearm free flap. D. Follow-up
DFSP: dermatofibrosarcoma protuberans
Figure 2
Figure 2. A: DFSP - nape of the neck. B: Defect and elevated trapezius myocutaneous flap. C: Follow-up
DFSP: dermatofibrosarcoma protuberans
Figure 3
Figure 3. A: DFSP of scalp. B: Reconstruction with a scalp rotation flap. C&D: Follow-up
DFSP: dermatofibrosarcoma protuberans
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