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Case Reports
. 2025 Jan 9:58:109-114.
doi: 10.1016/j.jdcr.2024.12.026. eCollection 2025 Apr.

Cutaneous squamous cell carcinoma of the scalp surrounding a ventriculoperitoneal shunt in a renal transplant recipient with spina bifida

Affiliations
Case Reports

Cutaneous squamous cell carcinoma of the scalp surrounding a ventriculoperitoneal shunt in a renal transplant recipient with spina bifida

Po-Han Ho et al. JAAD Case Rep. .
No abstract available

Keywords: cutaneous oncology; cutaneous squamous cell carcinoma; immunosuppression; locally advanced disease; multidisciplinary care; transplant; ventriculoperitoneal shunt.

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Conflict of interest statement

Dr Chang has been a consultant and clinical investigator for Merck. Drs Chong, Fischbein, Abou-Taleb, Saoub, and Ho have no conflicts of interest to declare.

Figures

Fig 1
Fig 1
Cutaneous squamous cell carcinoma (CSCC) of the scalp in a spina bifida patient with a ventriculoperitoneal shunt (VPS) and a renal transplant on immunosuppression. (A) Photograph taken immediately prior to left scalp biopsy, which showed CSCC in situ (CSCCIS), taken 6 years prior to (B), before any treatment. The CSCCIS was treated with 5-fluorouracil (5-FU) cream, but development into CSCC necessitated Mohs surgery for the invasive component, with the in situ component treated with additional 5-FU cream. (B) The patient did not follow up for several years and then presented with a 13 cm ulcerated plaque on the left scalp overlying the prior CSCC site. The outline of the retroauricular portion of the subcutaneous VPS catheter was visible and palpable (yellow arrow), extending from the ulcer to the neck. Biopsy at least 3 cm away from the shunt (white dashed circle) confirmed invasive CSCC with perineural invasion. (C) Computed tomography (CT) scan of the head showed the VPS catheter (yellow arrow) surrounded by extensive calvarial destruction (blue arrows) and dural involvement (red arrows) by the CSCC. The neurosurgery team determined the CSCC was inoperable due to the extent of osseous and dural involvement. (D) The patient underwent multiple lines of systemic therapy over the next 13 months, with CSCC response evident (yellow arrow) after carboplatin/paclitaxel.

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