Longo Benedetto, Paolini Guido, Belli Evaristo, Costantino Brando, Pagnoni Marco, Santanelli Fabio
From the *Plastic Surgery Unit, and †Maxillofacial Surgery Unit, Department of Neuroscienze, Salute Mentale e Organi di Senso, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
J Craniofac Surg. 2013 Nov;24(6):e597-9. doi: 10.1097/SCS.0b013e3182a238c1.
Dermatofibrosarcoma protuberans is a rare cutaneous malignant tumor associated with a high cure rate but with a high incidence of local recurrence. Because of its tentacle-like subcutaneous infiltrating pattern that extends far beyond the clinically visible skin lesion, a wide resection margin is recommended. Hence, its localization to the head-and-neck regions, although rare, represents a real challenge for both the oncologic surgeon and the reconstructive surgeon, who aim to achieve a radical resection of the tumor with the best possible aesthetic outcome.A case of a 21-year-old Mediterranean man who presented with a 7-month history of a slowly growing subcutaneous lesion of the left preauricular region is reported. A diagnosis of dermatofibrosarcoma protuberans CD34+ was confirmed through surgical biopsy, and the patient subsequently underwent a wide en bloc local surgical resection, followed by anterolateral thigh perforator free flap reconstruction. Healing was uneventful. Initially, there was some facial nerve neurapraxia; however, this completely subsided within 3 months after the surgery. At the 13-month follow-up, the patient was completely well and free from the disease.
隆突性皮肤纤维肉瘤是一种罕见的皮肤恶性肿瘤，治愈率较高，但局部复发率也较高。由于其呈触手状的皮下浸润模式，其延伸范围远远超出临床上可见的皮肤病变，因此建议进行广泛的切缘切除。因此，尽管其在头颈部区域的定位很少见，但对于肿瘤外科医生和重建外科医生来说都是一个真正的挑战，他们的目标是在尽可能达到最佳美学效果的同时实现肿瘤的根治性切除。本文报道了一例21岁的地中海男性患者，其左耳前区域出现一个缓慢生长的皮下病变，病程7个月。通过手术活检确诊为CD34 +隆突性皮肤纤维肉瘤，患者随后接受了广泛的整块局部手术切除，然后进行了股前外侧穿支游离皮瓣重建。愈合过程顺利。最初，存在一些面神经失用；然而，这在手术后3个月内完全消退。在13个月的随访中，患者完全康复，未患疾病。
