Abstract
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare proliferative condition representing skin sarcomas known to locally recur yet very rarely known to metastasize. A typical characteristic is trunk localization, making vulvar occurrences an exception. Complete resection is the primary treatment. CASE REPORT: We present an unusual case of twice-recurrent vulvar DFSP in a 92-year-old woman. Wide local excision with tumor-negative margins (R0 resection) of a grapefruit-sized mass was followed by a rhomboid skin flap transplantation to address a substantial skin deficit at the post excision site. At 14-month follow-up, no signs of recurrence were present, all wounds were healed, and the esthetic results were assessed as highly adequate. CONCLUSIONS: This study is an argument for the role of reconstructive surgery in patients of advanced age undergoing oncological procedures; skin transplantations should be considered regardless of the patient's age. We also provide an updated review on vulvar DFSP.