en تخصصي Special مقالات اصيل Original Article <span style="font-size:12pt"><span style="line-height:200%"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif"></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:200%"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif">Dermatofibrosarcoma protuberans (DFSP) of Darier and Ferrand located on the head is frequently hemorrhagic. Reconstruction following oncologic resection must carefully balance functional preservation with esthetic outcomes. A 54-year-old woman presented with a recurrent, hemorrhagic tumor on the forehead extending onto the scalp. She underwent surgery by a multidisciplinary team comprising plastic and neurosurgeons. A right anterior cervicotomy was performed. A loop was placed around the external carotid artery (ECA) for a temporary clamping when facing a massive bleeding during the resection of the tumor. Bipolar cautery, targeting ECA branches was done along with progressive running vicryl sutures on the resected margins. A wide oncologic resection of the tumor was carried out.&nbsp; Burring of the outer calvarial table was performed. A split-thickness skin graft was applied after a granulation achieved by a secondary intention wound healing. Residual alopecia was cosmetically concealed with a wig. Histopathological examination confirmed DFSP with negative surgical margins. At 10-year follow-up, the patient remained recurrence-free and expressed high satisfaction with the outcome. This case highlights the management of an hemorrhagic dermatofibrosarcoma protuberans of the head in a limited resource setting where plastic surgeons and neurosurgeons are available. Exposure and placing a vascular loop around the external carotid artery is encouraged. This enables temporary clamping of the artery when facing a massive bleeding. Resection must be wide and oncologically sound. Burring of the outer table of the calvarium is essential when split-thickness skin grafting is selected for defect coverage. </span></span></span></span><br> &nbsp; Scalp bone burring, Scalp reconstruction, Scalp tumor, SCARE case report, Temporary arterial clamping 0 0 http://wjps.ir/browse.php?a_code=A-10-1173-3&slc_lang=en&sid=1 Valérie Dje Bi Dje – Assi assi_valerie@yahoo.fr 100319475328460018312 100319475328460018312 Yes 1. Department of Plastic and Reconstructive and Aesthetic, Hand Surgery and Burn, Teaching Hospital of Treichville, Medical and Sciences Faculty, University Felix Houphouet Boigny, Ivory Coast Yvan Zunon-Kipre 100319475328460018313 100319475328460018313 No 2. Department of Neurosurgery, Teaching Hospital of Yopougon, Medical and Sciences Faculty, University Felix Houphouet Boigny, Ivory Coast Konan Christophe Allah 100319475328460018314 100319475328460018314 No 1. Department of Plastic and Reconstructive and Aesthetic, Hand Surgery and Burn, Teaching Hospital of Treichville, Medical and Sciences Faculty, University Felix Houphouet Boigny, Ivory Coast Dorian Nasser 100319475328460018315 100319475328460018315 No 3. Department of Otorhinolaryngology and Cervico Facial Surgery, Teaching Hospital of Treichville, Medical and Sciences Faculty, University Felix Houphouet Boigny, Ivory Coast Jean-Baptiste Sie-Essoh 100319475328460018316 100319475328460018316 No 4. Department of Orthopedics Surgery, Teaching Hospital of Yopougon, Medical and Sciences Faculty, University Felix Houphouet Boigny, Ivory Coast