Definitive cranioplasty and scalp reconstruction in recurrent dermato fibrosarcoma protuberance of scalp

Abstract

Dermatofibrosarcoma protuberans (DFSP) of the scalp is a relatively uncommon soft-tissue neoplasm. Calvarial involvement can lead to a quick intracranial spread making the tumor incurable. The management of DFSP scalp, especially recurrent lesions with calvarial involvement should be a team approach with close cooperation between the neurosurgeon and the reconstructive surgeon. The failure to excise the underlying periosteum is one of the major reasons for early calvarial spread. At no stage adequate excision, i.e., 5 cm margin and removal of underlying periosteum should be compromised. In developing world where follow-up of patients is difficult and specialized health services are at a premium we believe that a wide surgical excision, including the underlying periosteum and cranioplasty followed by local flap cover if possible will provide the best results with the shortest downtime.

Keywords

• cranioplasty
• dermatofibrosarcoma
• reconstruction
• scalp