Recurrent Dermatofibrosarcoma Protuberans of the Clavicular Region: Radical Excision and Reconstruction With Latissimus Dorsi Myocutaneous Flap

Abstract

Dermatofibrosarcoma protuberans (DFSP) is a soft tissue tumor with high propensity for local recurrence. We present a case of a 53-yearold woman with a recurrent DFSP of the clavicular region. The patient underwent extensive local excision including the external cortical bone of the left clavicle. The resulting large defect was reconstructed using pedicled Latissimus Dorsi myocutaneous flap. The histopathological examination confirmed dermatofibrosarcoma protuberans with clear surgical margins and the patient was satisfied with the final aesthetic result.

Clinical recommendations for diagnosis and treatment according to current updated knowledge on BIA-ALCL

“…For this reason, it is not recommended and should be avoided any type of implant placement, neither textured or smooth, after the en-bloc capsulectomy both in aesthetic and reconstructive patients. Conversely, it is highly recommended to opt for an autologous breast reconstruction, using indifferently free flaps, FALD flap or autologous fat grafting alone [ [72] , [73] , [74] , [75] ]. Removal of the contralateral breast implant should be performed, since in a low percentage of cases BIA-ALCL also involved the contralateral breast [ 76 ].…”

Clostridium Septicum Fasciitis in a Patient With Occult Colon Malignancy: A Case Report and Literature Review

“…Definitive soft tissue coverage is often represented by a delayed primary closure or skin graft/local flaps after the infection is completely resolved, depending on patient's general conditions. Further reconstructive options for soft tissue coverage, including local or free flaps were considered in our case 22,23 . However, a more complex reconstruction a part of skin grafts was not feasible due to patient's general conditions and the underlying paraneoplastic anemia, which dictated the surgical management of the gangrene.…”

Letter to the Editor: Thoraco-Acromial Artery Perforator (Taap) Flap for Reconstruction of a Recurrent Dermatofibrosarcoma Protuberans of the Clavicular Region

“…We read with interest the recent article published by Longo et Al. "Recurrent dermatofibrosarcoma protuberans of the clavicular region: radical excision and reconstruction with Latissimus Dorsi myocutaneous flap" 1 . This article reports a difficult case of recurrent dermatofibrosarcoma protuberans (DFSP) of the clavicular region.…”

“…Nevertheless, in female patients or for wider defects, the TAAP flap may be not suitable because of its anterior scar pattern and its limited paddle dimensions. We thank Cavaliere and Schonauer for their letter in response to our paper "Recurrent dermatofibrosarcoma protuberans of the clavicular region: radical excision and reconstruction with Latissimus Dorsi myocutaneous flap" 1 . The Authors reported their previously published paper 2 , which highlighted the existence of a "hot spot" of dermatofibrosarcoma protuberans (DFSP) localized in the subclavicular/parasternal region of the left chest, which is the same site reported in our patient.…”