ABSTRACT
Skin cancer involving the scalp is a common malignancy in the “sun belt areas of the United States.” Most early lesions are well managed by primary care physicians and dermatologists. Occasionally we encounter basal cell, squamous cell, and rarely Merkel cell carcinomas that have failed local therapy and present with large tumors invading full thickness scalp, calvarium, and even underlying dura. We describe our experience with 52 such tumors and illustrate their resections and reconstruction. For full thickness lesions we generally do a wide field resection of skin and underlying calvarium followed by dural resection. Reconstruction is usually with dural replacement, calvarial reconstruction with titanium mesh, and cutaneous reconstruction with a musculocutaneous free flap or muscular free flap with an overlying skin graft. Complications, survival rates, and recurrence rates will be presented.
KEYWORDS
Skull base - skin cancer - otolaryngology - surgery - scalp carcinoma - free flap - dural invasion
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Paul James DonaldM.D. F.R.C.S.(C.)
Professor and Vice Chair, Department of Otolaryngology-Head and Neck Surgery, University of California, Davis
2521 Stockton Boulevard, Suite 7200, Sacramento, CA 95817
Email: mary.mccarthy@ucdmc.ucdavis.edu
