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Review
. 2022 Apr 1;30(2):119-124.
doi: 10.1097/MOO.0000000000000746.

Comprehensive management of nonmelanoma skin cancer involving the skull base

Leandro Luongo Matos  1   2   3 , Claudio Roberto Cernea  4
Affiliations
Review

Comprehensive management of nonmelanoma skin cancer involving the skull base

Leandro Luongo Matos et al. Curr Opin Otolaryngol Head Neck Surg. .

Abstract

Purpose of review: Skin cancers are the most prevalent malignant disorder affecting humans. Approximately 90% of these are nonmelanoma skin cancer (NMSC), and large tumors, especially at the 'H-zone', can invade deeply and access the skull base. The best treatment for these very advanced skin cancers is craniofacial resection followed by adjuvant treatment, but, currently, systemic therapy and neoadjuvant approaches could be considered for some patients. The current management of NMSC involving the skull base is discussed in this article.

Recent findings: Surgical resections with negative margins followed by adjuvant treatment are the best treatment for NMSC with skull base invasion and offer the best outcomes for those patients. This approach usually requires a free flap reconstruction, followed by external beam radiation therapy. The team must keep in mind that some factors, such as gross brain invasion and extensive dura mater extension, are associated with worse outcomes.

Summary: Although it occurs infrequently, very advanced NMSC can involve the skull base. In these very difficult clinical scenarios, the best therapeutic option is a multidisciplinary approach in a tertiary center.

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References

    1. Cakir BO, Adamson P, Cingi C. Epidemiology and economic burden of nonmelanoma skin cancer. Facial Plast Surg Clin N Am 2012; 20:419–422.
    1. Maghami EG, Talbot SG, Patel SG, et al. Craniofacial surgery for nonmelanoma skin malignancy: report of an international collaborative study. Head Neck 2007; 29:1136–1143.
    1. Dias FL, Sa GM, Kligerman J, et al. Prognostic factors and outcome in craniofacial surgery for malignant cutaneous tumors involving the anterior skull base. Arch Otolaryngol Head Neck Surg 1997; 123:738–742.
    1. Cernea CR, Teixeira GV, Medina dos Santos LR, et al. Indications for, contraindications to, and interruption of craniofacial procedures. Ann Otol Rhinol Laryngol 1997; 106:927–933.
    1. Donald PJ, Boggan J, Farwell DG, Enepekides DJ. Skull base surgery for the management of deeply invasive scalp cancer. Skull Base 2011; 21:343–350.