Dermatofibrosarcoma protuberans of the cheek - Case report

Dermatofibrosarcoma protuberans is an uncommon tumor. It is believed to be of fibroblastic origin. The tumor more frequently occurs on the trunk and extremities (about 89% of all cases), and less on the head and neck (about 11%). The tumor grows slowly and it's clinical course is marked by locally aggressive invasion with rare metastasis. It occurs with approximately equal frequencies among the sexes. Most cases occur between the ages of 20 and 50 years. The high recurrence rate has been attributed to peripheral extension of the tumor and inadequate excision. This report presents a 53 year old man who had developed a progressively growing painless mass, 2 x 2.5 cm in size, on the left check area for about 6 months. He received an excisional biopsy of the lesion by a local doctor and the histologic examination revealed dermatofibrosarcoma protuberans. Intraoperatively, the parotid gland and the frontal and zygomatic branches of facial nerve were found to be invaded. Therefore wide resection of the cheek skin and parotid gland were performed and the facial nerve branches were sacrificed. Then, the facial nerve and cheek defect were reconstructed by nerve grafting and cheek rotation- advancement skin flap respectively. The patient has been free of tumor recurrence till now.