Taming widow Dimanche’s horn: excision and reconstruction of recurrent dermatofibrosarcoma protuberans of the forehead

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma primarily found on the trunk and proximal extremities that typically appears as a slowly progressing, firm, violet-red, or blue plaque. In this case report, we describe our experience with a patient who presented with recurrent DFSP of the forehead of size 10 × 6 cm. Patient underwent wide local excision and reconstruction with a rotational scalp flap and split skin graft (SSG) cover. No early or late complications were observed in the patient. The flaps survived completely and SSG had full uptake. This surgical technique allowed a radical excision of forehead DFSP, thus potentially decreasing tumor recurrence rate. All main reconstructive criteria, such as functional and cosmetic tissue characteristics, were completely fulfilled.