Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone

INTRODUCTION: Dermatofibrosarcoma protuberans is a rare skin tumor with intermediate malignancy and low metastatic potential, but a high recurrence rate after surgical treatment. Treatment involves extended resection with variable margins. METHODS: Patients were managed with preceding ex...

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Main Authors: Erick Horta Portugal, José Carlos Ribeiro Resende Alves, Aloísio Ferreira da Silva Filho, Rebeca Paohwa Liu da Fonseca, Nárlei Amarante Pereira, Augusto César de Melo Almeida, José de Souza Andrade Filho
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2017-12-01
Series:Revista Brasileira de Cirurgia Plástica
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Online Access:http://www.rbcp.org.br/export-pdf/1902/en_v32n4a21.pdf
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author Erick Horta Portugal
José Carlos Ribeiro Resende Alves
Aloísio Ferreira da Silva Filho
Rebeca Paohwa Liu da Fonseca
Nárlei Amarante Pereira
Augusto César de Melo Almeida
José de Souza Andrade Filho
author_facet Erick Horta Portugal
José Carlos Ribeiro Resende Alves
Aloísio Ferreira da Silva Filho
Rebeca Paohwa Liu da Fonseca
Nárlei Amarante Pereira
Augusto César de Melo Almeida
José de Souza Andrade Filho
author_sort Erick Horta Portugal
collection DOAJ
description INTRODUCTION: Dermatofibrosarcoma protuberans is a rare skin tumor with intermediate malignancy and low metastatic potential, but a high recurrence rate after surgical treatment. Treatment involves extended resection with variable margins. METHODS: Patients were managed with preceding expansion of tissues of the forehead using two conventional expanders. The lateral margins of normal-appearing tissue 3-cm apart were tattooed with China ink. In a preceding operation, expanders were inserted through skin incisions at a distance from the marks, by undermining the surgical plane just above the periosteum, while preserving the area of wide resection previously delimited. After the lateral tissues were expanded, the patients underwent surgical resection. The deep margin included the outer table of the frontal bone. The expansion period averaged 45 days. RESULTS: Three cases of dermatofibrosarcoma protuberans of the forehead with involvement of the outer table of the frontal bone are described. The expanded flaps easily closed the defects. The average follow-up was 194 months without tumor recurrence. CONCLUSION: Preceding expansion of forehead tissue in the treatment of dermatofibrosarcoma protuberans with invasion of frontal bone, using 3-cm lateral margins and removal of the outer table of the frontal bone, allowed easy closure of the defect in 3 different patients. Average follow-up of 194 months with no recurrence of the lesion showed the effectiveness of the method.
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spelling doaj-art-a52d73e642cf4739b1719db7c18ea1592025-08-20T02:51:34ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352017-12-01320459960210.5935/2177-1235.2017RBCP0097Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal boneErick Horta Portugal0José Carlos Ribeiro Resende Alves1Aloísio Ferreira da Silva Filho2Rebeca Paohwa Liu da Fonseca3Nárlei Amarante Pereira4Augusto César de Melo Almeida5José de Souza Andrade Filho6Sociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilSociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilSociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilSociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilSociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilSociedade Brasileira de Cirurgia Plástica, São Paulo, SP, BrazilHospital Felício Rocho, Belo Horizonte, MG, BrazilINTRODUCTION: Dermatofibrosarcoma protuberans is a rare skin tumor with intermediate malignancy and low metastatic potential, but a high recurrence rate after surgical treatment. Treatment involves extended resection with variable margins. METHODS: Patients were managed with preceding expansion of tissues of the forehead using two conventional expanders. The lateral margins of normal-appearing tissue 3-cm apart were tattooed with China ink. In a preceding operation, expanders were inserted through skin incisions at a distance from the marks, by undermining the surgical plane just above the periosteum, while preserving the area of wide resection previously delimited. After the lateral tissues were expanded, the patients underwent surgical resection. The deep margin included the outer table of the frontal bone. The expansion period averaged 45 days. RESULTS: Three cases of dermatofibrosarcoma protuberans of the forehead with involvement of the outer table of the frontal bone are described. The expanded flaps easily closed the defects. The average follow-up was 194 months without tumor recurrence. CONCLUSION: Preceding expansion of forehead tissue in the treatment of dermatofibrosarcoma protuberans with invasion of frontal bone, using 3-cm lateral margins and removal of the outer table of the frontal bone, allowed easy closure of the defect in 3 different patients. Average follow-up of 194 months with no recurrence of the lesion showed the effectiveness of the method.http://www.rbcp.org.br/export-pdf/1902/en_v32n4a21.pdftissue expansion devicestissue expansiondermatofibrosarcomaskin neoplasmsfrontal bone
spellingShingle Erick Horta Portugal
José Carlos Ribeiro Resende Alves
Aloísio Ferreira da Silva Filho
Rebeca Paohwa Liu da Fonseca
Nárlei Amarante Pereira
Augusto César de Melo Almeida
José de Souza Andrade Filho
Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone
Revista Brasileira de Cirurgia Plástica
tissue expansion devices
tissue expansion
dermatofibrosarcoma
skin neoplasms
frontal bone
title Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone
title_full Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone
title_fullStr Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone
title_full_unstemmed Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone
title_short Preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone
title_sort preceding expansion in the treatment of dermatofibrosarcoma protuberans involving the frontal bone
topic tissue expansion devices
tissue expansion
dermatofibrosarcoma
skin neoplasms
frontal bone
url http://www.rbcp.org.br/export-pdf/1902/en_v32n4a21.pdf
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