Dermatofibrosarcoma protuberans of the head and neck: case report using combined surgical approach

Abstract

Introduction: The surgical and reconstructive management of malignant tumours of the head and neck have always presented unique challenges, particularly as they occur in such a cosmetically significant area. The aim for surgical resection emphasises adequate oncological control of the tumour, which often leaves large soft tissue defects requiring complex surgical techniques for reconstruction. In this report the authors present a case of a dermatofibrosarcoma protuberans in the head and neck which was resected, leaving a large superficial soft tissue defect in the neck and face. Reconstruction and closure of the defect was achieved with a combination of a regional fasciocutaneous flap, dermal regeneration template and later skin grafting. Materials and methods: A 65-year-old female patient presented to the Kimberley Hospital Complex. The patient underwent a wide local excision of a head and neck dermatofibrosarcoma protuberans by the Department of Maxillofacial Surgery followed by surgical reconstruction by the Department of Plastic and Reconstructive Surgery. Results: The combined approach of a regional fasciocutaneous flap, dermal regeneration template and skin graft were used to achieve an aesthetically adequate closure of the large wound left after excision of the head and neck tumour. Conclusion: This presented technique provides a good reconstructive option for the management of soft tissue head and neck tumours which leave large defects following resection with curative objectives, particularly in settings such as ours where more complex reconstructive techniques are limited by a combination of factors.