Acellular dermal matrix for breast reconstruction after surgery for giant dermatofibrosarcoma protuberans

Area of Science:

• Oncology
• Surgical Oncology
• Plastic and Reconstructive Surgery

Background:

• Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous neoplasm that can exceptionally occur in the breast.
• Intraparenchymal DFSP is exceedingly rare, often requiring extensive surgical resection due to its infiltrative nature.

Observation:

• A 34-year-old woman presented with a rapidly enlarging 12 cm breast mass.
• Radiological findings were suggestive of a giant fibroadenoma or mesenchymal neoplasm.
• Histological examination confirmed Dermatofibrosarcoma protuberans infiltrating the breast parenchyma.

Findings:

• A nipple sparing mastectomy was performed due to the tumor's size.
• Reconstruction utilized an Acellular Dermal Matrix (ADM) mesh to cover a prosthesis placed over the pectoral muscle.
• Final pathology confirmed no neoplastic infiltration in the resected parenchyma or skin.

Implications:

• The patient remained recurrence-free at 24 months with excellent cosmetic results.
• Nipple sparing mastectomy is a viable option for intraparenchymal DFSP when the skin is not compromised.
• ADM-wrapped prosthesis reconstruction offers a time-efficient, low-complication approach for breast reconstruction after DFSP treatment.