Dermatofibrosarcoma protuberans of the face: surgical management

Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive, rarely metastatic, spindle cell tumor. It is most commonly found on the trunk and rarely on the head and neck. Recurrence has been found to be more common in the head and neck region, which may be attributable to delayed patient presentation or a reluctance for wide excision in that region. The authors report a rare case of DFSP presenting as a large mass of the face. Surgical treatment required aggressive local resection of the tumor, including the underlying maxillary antrum. The soft tissue was cleared by Mohs technique. More than one procedure was required to obtain clear bone margins. Adjuvant radiation therapy was used to gain local control. Reconstruction was performed using a cheek advancement flap, as well as a forehead flap and split-thickness graft to the donor site.