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Case Reports
. 2016 Nov 8:16:e29.
eCollection 2016.

Invasive Squamous Cell Carcinoma of the Scalp and Calvarium: A Multidisciplinary Approach

Jennifer Stark  1 , Silvio Podda  1 , Karen Szymanski  1
Affiliations
Case Reports

Invasive Squamous Cell Carcinoma of the Scalp and Calvarium: A Multidisciplinary Approach

Jennifer Stark et al. Eplasty. .

Abstract

Objective: The correlation between immunosuppression-associated skin cancer and lymphoma has been well established. This includes squamous cell carcinoma and chronic lymphocytic leukemia. When a lesion requires excision, reconstruction can be challenging based on the depth and size of the tumor. We present a patient with chronic lymphocytic leukemia and invasive squamous cell carcinoma of the scalp that extended through the calvarium to the dura mater. His tumors were badly neglected for a long period of time and presented at an advanced stage. Methods: This type of reconstruction was performed utilizing a multidisciplinary approach. Our patient required calvarial reconstruction with titanium mesh, dural reconstruction, latissimus dorsi free flap, and an overlying skin graft. Results: The patient had appropriate resection of his tumor while maintaining flap viability. Postoperatively, he presented with excellent soft-tissue thickness and aesthetic result. Conclusion: We believe that this type of reconstruction was best, considering our patient had a significant scalp and calvarial defect at presentation. Using a latissimus dorsi free flap bestows a robust blood supply to help decrease infections and improve healing and circulation, especially in light of the need of further radiation therapy.

Keywords: free flap reconstruction of the calvarium; latissimus dorsi free flap; microsurgical reconstruction; skull base reconstruction; squamous cell carcinoma and chronic lymphocytic leukemia.

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Figures

Figure 1
Figure 1
Scalp with invasion through to the calvarium/dura shown.
Figure 2
Figure 2
Excision of the tumor from scalp, calvarium, and dura.
Figure 3
Figure 3
Latissimus dorsi flap contoured to the calvarium.
Figure 4
Figure 4
Postoperative result: 4 weeks after skin graft.
See this image and copyright information in PMC

References

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