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Bonomi et al. Plast Aesthet Res 2018;5:8 Plastic and
DOI: 10.20517/2347-9264.2017.93 Aesthetic Research

Case Report Open Access

Reverse bilateral latissimus dorsi flap
reconstruction after extensive mid back

dermatofibrosarcoma protuberans excision:
a case report

Stefano Bonomi , Laura Sala , Alessandro Gronchi , Dario Callegaro , Umberto Cortinovis 1
1
1
2
2
1 Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan 20133, Italy.
2 Sarcoma Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan 20133, Italy.
Correspondence to: Dr. Stefano Bonomi, Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale dei
Tumori, Via Venezian 1, Milan 20133, Italy. E-mail: stefano.bonomi@istitutotumori.mi.it
How to cite this article: Bonomi S, Sala L, Gronchi A, Callegaro D, Cortinovis U. Reverse bilateral latissimus dorsi flap
reconstruction after extensive mid back dermatofibrosarcoma protuberans excision: a case report. Plast Aesthet Res 2018;5:8.
http://dx.doi.org/10.20517/2347-9264.2017.93

Received: 20 Dec 2017 First Decision: 23 Jan 2018 Revised: 2 Feb 2018 Accepted: 9 Feb 2018 Published: 6 Mar 2018

Science Editor: Taina A. Partanen Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
Surgical resection of soft tissue sarcoma of the trunk can result in large defects requiring complex reconstruction for
coverage of vital neurovascular structures and tissue defect. Large defects of the back could be reconstructed with
multiple random pattern or local pedicled flaps. We present the case of a 48-year-old patient with a locally advanced
dermatofibrosarcoma protuberans of the back. Wide local excision of the lesion was performed. The soft tissue defect
measured 22 cm × 20 cm × 4 cm and was reconstructed with bilateral reverse latissimus dorsi myocutaneous (RLDM)
flap. Each RLDM flap measured 24 cm × 10 cm. The donor site on the back was closed directly on both sides. The patient
recovered well and the two flaps healed uneventfully. Twelve months after surgery the patient is disease-free. The use
of a RLDM flap in mid-back reconstructions provided wide well-vascularized soft tissue, minimized risk of infection, and
maximized back coverage. This flap is an excellent choice for reconstruction of large defects of the mid-back.

Keywords: Reverse latissimus dorsi myocutaneous flap, trunk reconstruction, posterior trunk defect, sarcoma,
dermatofibrosarcoma protuberans

INTRODUCTION
Soft tissue sarcomas (STS) represent less than 1% of all malignant tumors. STS can occur anywhere in the
body but 75% are located in the extremities, 10% in the trunk and 10% in the retroperitoneum . The mainstay
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© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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