Akhtar Aqsa, Khan Adeela Hussain, Rashid Mamoon, Eitezaz Farhan, Ur Rashid Haroon
Plastic Surgery, Shifa International Hospital, Islamabad, PAK.
Plastic Surgery, Queen Elizabeth Hospital, Birmingham, GBR.
Cureus. 2020 Jul 27;12(7):e9423. doi: 10.7759/cureus.9423.
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.
目的 探讨隆突性皮肤纤维肉瘤（DFSP）患者的手术切除及各种重建选择。方法 本研究于2018年5月至2019年12月在巴基斯坦伊斯兰堡的希法国际医院进行。纳入在此期间确诊为DFSP的所有20岁及以上的患者，不分性别。所有患者均在全身麻醉下接受肿瘤广泛局部切除。所有病例均进行术中冰冻切片以确认完整切除。肿瘤切除后立即进行重建。重建方式的选择，即游离皮瓣、区域皮瓣或局部皮瓣，取决于所形成缺损的大小。结果 患者的平均年龄为37.11±10.91岁。男性12例（66.7%），女性6例（33.3%）。疾病的平均病程为11.22±2.94个月。受累解剖部位显示，大多数患者为面部，共9例（50%），其次是头皮4例（22.2%），颈后3例（16.7%），锁骨上区域2例（11.1%）。在大多数病例中，观察到采用游离皮瓣，即（n = 9，50%），其次是区域皮瓣7例（38.9%），局部皮瓣2例（10.1%）。结论 经冰冻切片证实的疾病广泛局部切除可提高生存率。在头颈部DFSP中，半数病例的受累解剖部位为面部。此外，对于DFSP患者，肿瘤切除后采用游离皮瓣重建是最有利的选择。
