Dermatofibrosarcoma Protuberans of the Forehead and Scalp with Involvement of the Outer Calvarial Plate: Multistaged Repair with the Use of Skin Expanders

• Published in: Dermatologic surgery Vol. 31; no. 1; pp. 115 - 119
• Main Authors: KHACHEMOUNE, AMOR, BARKOE, DAVID, BRAUN, MARTIN, DAVISON, STEVEN P
• Format: Journal Article
• Language: English
• Published: Malden, MA by the American Society for Dermatologic Surgery, Inc 01.01.2005; Blackwell
• Subjects: Adult; Biological and medical sciences; Dermatofibrosarcoma - surgery; Dermatology; Female; Forehead; General aspects; Humans; Medical sciences; Mohs Surgery; Scalp; Skin Neoplasms - surgery; Skin plastic surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Expansion Devices; Tumors of the skin and soft tissue. Premalignant lesions; Wound Healing - physiology; Skin disease; Sarcoma; Dermatology; Use; Malignant tumor; Outer; Plate; Forehead; Calvaria; Treatment; Scalp; Surgery; Dermatofibrosarcoma protuberans; Repair
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1097/00042728-200501000-00022

BACKGROUND AND OBJECTIVEDermatofibrosarcoma protuberans (DFSP) is a locally aggressive and infiltrative tumor that requires Mohsʼ 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. PATIENT AND METHODSWe 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. RESULTSA multistaged repair was performed with good clinical outcome and satisfactory cosmetic results. CONCLUSIONMultistaged 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.