Treatment of Wide Dermatofibrosarcoma Protuberans with Tissue Expander

ABSTRACT

Dermatofibrosarcoma protuberans is a slowly growing, locally invasive malignant tumor which originates in the dermis. Clinically, the initial appearance of the tumor is that of an indurated plaque which subsequently gives rise to multiple nodules. In the tumor's later stages, however, its growth rate accelerates, and it can ulcerate, bleed or become painful. but, metastasis is very rare. Dermatofibrosarcoma protuberans occurs most frequently on the trunk and proximal parts of the limbs, less commonly in the head and neck region, and only rarely in the extremities and external genitalia. A characteristic feature of dermatofibrosarcoma protuberans is the tendency to recur locally. This is apparently due to the infiltrative growth pattern between collagen bundles. Therefore, a wide excision is treatment of choice. Skin grafting is the usual reconstructive procedure, but flap reconstructions are used for cosmetic and functional concerns in many anatomic locations. We report the case of wide atrophic dermatofibrosarcoma protuberans and the clinical usefulness of the expanded cutaneous flap using tissue expander in reconstruction of the tissue deficit after wide and deep excision of dermatofibrosarcoma protuberans of the chest and anterior neck.