A desmoplastic fibroma of the mandible in an 11-year-old girl provided a difficult diagnosis because of its similarity, both clinically and histologically, to a low-grade fibrosarcoma following its rapid recurrence after primary local curettage. Immediate one-stage microvascular musculocutaneous reconstruction served to allow complete excision of the lesion and minimize the degree of psychological trauma. The differential diagnosis and the significance of cartilagenous elements present in the lesion are discussed.
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