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Peer-reviewedCC BY-NC-NDPlastic and reconstructive surgery. Global open

Overcoming Challenges of Recurrent Abdominal Wall Dermatofibrosarcoma Protuberans in a Low-resource Setting: Case Report From Ethiopia.

  • Dagmawi Geremew Zinaw1
  • Abraham G Negussie2,3
  • Ataklitie B Berhea2,3
  • Meheret B Demmissie3
  • Simeon M Mengistu3
  • Samuel G Adane4
  • Biswalo M Yango3
4 affiliations
  1. 1From the Department of Plastic and Reconstructive Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
  2. 2Division of Plastic and Reconstructive Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
  3. 3Department of Plastic and Reconstructive Surgery, ALERT Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.
  4. 4Department of General Surgery, Arsi University College of Health Sciences, Asela, Ethiopia.
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Abstract

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft-tissue sarcoma with high recurrence rates. Management of large, recurrent DFSP of the abdominal wall is particularly challenging in low-resource settings due to limitations in specialized care and reconstructive options. A 31-year-old man presented with a recurrent, extensive, fungating abdominal wall mass 8 years after previous surgery. A computed tomography scan revealed an extensive sarcomatous mass, and both fine needle aspiration cytology and incisional biopsy confirmed DFSP. Wide local excision with a 5-cm margin was performed, resulting in a full-thickness abdominal wall defect. Reconstruction was accomplished using a left external oblique myocutaneous flap and a combined pedicled superficial inferior epigastric artery flap with a groin flap (chimeric flap), after intra-abdominal coverage with omentum and mesh. Donor sites were resurfaced with split-thickness skin grafts. A minor wound dehiscence on postoperative day 8 was managed with bedside suturing. The patient was subsequently followed-up and, at the ninth postoperative month, demonstrated an optimal reconstructive outcome with no evidence of recurrence. He was then linked to the oncology unit for ongoing surveillance and care. In resource-limited settings, even extensive recurrent abdominal wall DFSP can be successfully managed with wide excision and strategic regional flap reconstruction when microsurgical options are unavailable.

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Cite

BibTeXRIS
BibTeX
@article{zinaw2026overcoming,
  title = {{Overcoming Challenges of Recurrent Abdominal Wall Dermatofibrosarcoma Protuberans in a Low-resource Setting: Case Report From Ethiopia.}},
  author = {Dagmawi Geremew Zinaw and Abraham G Negussie and Ataklitie B Berhea and Meheret B Demmissie and Simeon M Mengistu and Samuel G Adane and Biswalo M Yango},
  journal = {Plastic and reconstructive surgery. Global open},
  year = {2026},
  month = oct,
  doi = {10.1097/gox.0000000000008199},
  url = {https://europepmc.org/article/MED/42903483},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Overcoming Challenges of Recurrent Abdominal Wall Dermatofibrosarcoma Protuberans in a Low-resource Setting: Case Report From Ethiopia.
AU  - Dagmawi Geremew Zinaw
AU  - Abraham G Negussie
AU  - Ataklitie B Berhea
AU  - Meheret B Demmissie
AU  - Simeon M Mengistu
AU  - Samuel G Adane
AU  - Biswalo M Yango
PY  - 2026
DA  - 2026/10/19
JO  - Plastic and reconstructive surgery. Global open
DO  - 10.1097/gox.0000000000008199
UR  - https://europepmc.org/article/MED/42903483
AB  - Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft-tissue sarcoma with high recurrence rates. Management of large, recurrent DFSP of the abdominal wall is particularly challenging in low-resource settings due to limitations in specialized care and reconstructive options. A 31-year-old man presented with a recurrent, extensive, fungating abdominal wall mass 8 years after previous surgery. A computed tomography scan revealed an extensive sarcomatous mass, and both fine needle aspiration cytology and incisional biopsy confirmed DFSP. Wide local excision with a 5-cm margin was performed, resulting in a full-thickness abdominal wall defect. Reconstruction was accomplished using a left external oblique myocutaneous flap and a combined pedicled superficial inferior epigastric artery flap with a groin flap (chimeric flap), after intra-abdominal coverage with omentum and mesh. Donor sites were resurfaced with split-thickness skin grafts. A minor wound dehiscence on postoperative day 8 was managed with bedside suturing. The patient was subsequently followed-up and, at the ninth postoperative month, demonstrated an optimal reconstructive outcome with no evidence of recurrence. He was then linked to the oncology unit for ongoing surveillance and care. In resource-limited settings, even extensive recurrent abdominal wall DFSP can be successfully managed with wide excision and strategic regional flap reconstruction when microsurgical options are unavailable.
SN  - 2169-7574
ER  -