Dermatofibrosarcoma protuberans of the foot ?surgical treatment with defect covering by radial forearm flap Report of a case with review of the literature

Abstract

Dermatofibrosarcoma protuberans (DFSP) is an unusual cutaneous neoplasm that originates in the dermis. This tumor belongs to the so-called low grade soft tissue sarcomas. The recurrence rate after simple surgical treatment is very high, and initial radical surgical treatment is indicated. In recurrences, the infiltrative growth often leads to invasion of vital structures and may ultimately lead to amputation of extremities. In the case reported, there was an initial misdiagnosis of dermatofibroma; the lesion recurred and was reported as DFSP. It was resected radically, and the defect was covered by a radial forearm flap. The radial forearm flap offers an effective one-stage method of soft tissue reconstruction which allows early mobilization and rehabilitation. After excision of a recurrence on the margin of the free flap 36 months after the first treatment, a deep infiltrating recurrence 12 months later made amputation necessary. The location of DFSP on the plantar aspect of the foot has not been reported previously. A brief review of the literature is presented.