Recurrent abdominal wall dermatofibrosarcoma protuberans in a child: a challenging reconstruction

Area of Science:

• Oncology
• Surgical Oncology
• Pediatric Surgery

Background:

• Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade soft tissue sarcoma.
• DFSP exhibits a high recurrence rate due to its infiltrative growth pattern.

Purpose of the Study:

• To present a case of a large, recurrent DFSP in a child's abdominal wall.
• To highlight the reconstructive challenges and solutions for extensive abdominal wall defects in pediatric patients.

Main Methods:

• A case report detailing the surgical management of a pediatric DFSP.
• Involved peritoneum-sparing resection, meshplasty, and free anterolateral thigh flap reconstruction.

Main Results:

• A large composite defect exceeding half the anterior abdominal wall required reconstruction.
• Free flap reconstruction, though technically demanding in children, proved to be the sole viable option.

Conclusions:

• Complete surgical excision is critical for abdominal wall DFSP.
• Microvascular free flaps are the only reconstructive option for large defects, necessitating specialized expertise.