Single-institution review of managing dermatofibrosarcoma protuberans.

Wide local excision with 2-cm gross margins remains the mainstay of treatment. Lesions in the head and neck region tend to have smaller margins and a greater likelihood of positive margins. We propose that the initial resection must be aggressive, even if a flap is necessitated. Frozen section histology with immediate re-resection reduces the need for repeat surgeries. Primary closure is ideal; but in areas where complex reconstruction is required, it is prudent to delay until final histology has cleared the margins.