Introduction: Managing complex defects of the abdominal wall has been a challenge for general and reconstructive surgeons since the year 2000. Fewer studies have been carried out on anterior abdominal wall reconstruction following excision of peripheral
primitive neuroectodermal tumor, and there is currently a dearth of information in a systematic review.

Materials and methods: A 26-year-old female of African descent was received in one the largest faith based hospital on Kenya with a four-year history of anterior abdominal wall swelling. She underwent wide local excision and reconstruction of the defect using a mesh and ALT fasciocutaneous free flap

Results: The patient responded positively to the surgical intervention and tolerated well the surgical procedures. 100% of the flap survived and had the post excision margins were all free of tumor.

Conclusion: Abdominal wall reconstruction is a complex surgical procedure aimed at restoring the structural integrity and functional capacity of the abdominal wall following trauma, surgery, or disease. The use of free ALT fasciocutaneous flap as well as mesh in abdominal wall reconstruction provides durable reinforcement and
reducing the risk of hernia recurrence.

Keywords: Abdominal wall, primitive neuroectodermal tumor, histology, free flap