A 42-year-old woman presented with a nodular lesion in the left genian region of several months duration.
Facial CT scan showed increased density of the fat tissue subcutaneous, skin and muscle.
The image was rounded and showed minimal enhancement with IV contrast.
The biopsy report was dermatofibrosarcoma probands.
The treatment consisted of wide surgical removal including skin of the genian region, part of the upper lip, genial and vestibular mucosa and buccal branch of the facial nerve.
The reconstruction was performed with a radial fasciocutaneous free flap that included a segment of the greater Palmar tendon for the suspension of the upper lip and oral commissure.
The flap was folded over itself allowing the closure of cutaneous and mucosal defect, and the two extremes of the tendon were fixed to the buccal commissure of the temporal osteotome muscle and the co tendon in the form of tape.
After 6 months, the flap was correctly adapted and the lip commissure was elevated.
