Aesthetic Reconstruction of Secondary Wounds after Extended Resection of Dermatofibrosarcoma Protuberans: A Retrospective Study in One Center.

Background: Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue malignancy with aggressive growth.

Objective: To summarize the surgical treatment and results of DFSP based on a case series and literature review.

Methods: Seventeen DFSP cases were analyzed retrospectively at our hospital from June 2016 to December 2022, including 14 males and 3 females. All these cases were treated by wide local excision with negative margins. Postoperative follow-up was performed to observe recurrence, survival, and the effect of wound repair.

Results: Routine postoperative pathology confirmed the morphological subtypes of these cases, including 12 cases of classical DFSP, 3 cases of DFSP-fibrosarcoma, 1 case of myxoid, and 1 case of Bednar. The median defect size was 72 cm2 (interquartile range 20-750 cm2). All patients required split skin (47.1%) or local flap (52.9%) to reconstruct the soft tissue defect caused by tumor resection. All split-skin grafts were viable, and one flap case had marginal necrosis, which healed by dressing change. After 6-32 months of follow-up, local recurrence occurred in 1 case, and extensive intra-abdominal metastasis and death occurred in another case.

Conclusions: Wide local excision with negative margins can achieve a favorable prognosis in classical DFSP. The use of flaps for reconstruction results in better appearance and function.