Resection of acral fibromyxoma tumor at the digital tip and reconstruction with advancement flap. A case report

Background: Acral fibromyxoma is a rare benign soft tissue tumor that usually develops in the periungual or subungual region of the digits. Although histologically benign, its infiltrative growth pattern and tendency for local recurrence require complete surgical excision with tumor-free margins. In digital tip lesions, this approach may result in tissue defects that compromise both functional and aesthetic outcomes. Local advancement flaps represent an optimal reconstructive option, providing tissue of similar thickness, color, and sensitivity, while minimizing donor site morbidity. Compared to skin grafts, local flaps allow for improved healing, preservation of the nail apparatus, and restoration of protective sensibility. The combination of complete surgical resection with local flap reconstruction ensures oncological safety, reduces recurrence risk, and enhances functional and cosmetic recovery. Therefore, this technique should be considered the first-line surgical strategy for the management of acral fibromyxoma in the digital tip. Keywords: Acral fibromyxoma, Advancement flap, Digital reconstruction