Invasive cutaneous squamous cell carcinoma of scalp: A case report

Dahal, Alok; Neupane, Durga; Lageju, Nimesh; Jaiswal, Lokesh Shekher; Chaudhary, Sushant; Budhathoki, Arpana Chhetri; Sah, Shiva Pratik; Subedi, Sushil

doi:10.1016/j.amsu.2022.104702

Cited by 3 publications

(9 citation statements)

References 10 publications

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“…The scalp is one of the main locations of cSCC, which presents with high-risk or very-high-risk features and can often show local invasion at the moment of clinical presentation. Therefore, since advanced cSCC of the scalp may impose significant risks in terms of impacts on quality of life, morbidity, and mortality, as well as increased costs for management, a systematic approach to treatment is mandatory [ 2 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Multidisciplinary Management of Cutaneous Squamous Cell Carcinoma of the Scalp: An Algorithm for Reconstruction and Treatment

Rodio,

Tettamanzi,

Trignano

et al. 2024

JCM

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Background: Scalp-associated cutaneous squamous cell carcinoma (cSCC) presents formidable treatment challenges, especially when it leads to full-thickness defects involving bone. Aggressive or recurring cases often demand a multidisciplinary approach. Leveraging our surgical experience and a literature review, we introduce a therapeutic algorithm to guide the selection of reconstruction methods, particularly for locally advanced lesions, furthermore showing the synergy between surgery and other therapies for comprehensive, multidisciplinary disease management. Methods: Our algorithm stems from a retrospective analysis of 202 patients undergoing scalp cSCC resection and reconstruction over a 7-year period, encompassing 243 malignancies. After rigorous risk assessment and documentation of surgical procedures, reconstruction methods were therefore related to malignancy extent, depth, and individual clinical status. Results: The documented reconstructions included 76 primary closures, 115 skin grafts, 7 dermal substitute reconstructions, 33 local flaps, 1 locoregional flap, and 1 microsurgical free flap. Patients unsuitable for surgery received radiotherapy or immunotherapy after histological confirmation. Precise analysis of tumor characteristics in terms of infiltration extent and depth guided the selection of appropriate reconstruction and treatment strategies Combining these insights with an extensive literature review enabled us to formulate our algorithm for managing scalp cSCCs. Conclusions: Effectively addressing scalp cSCC, especially in locally advanced or recurrent cases, demands a systematic approach integrating surgery, radiotherapy, and immunotherapy. Our multidisciplinary team’s decision-making algorithm improved patient outcomes by offering a broader spectrum of therapeutic options that can synergistically achieve optimal results.

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Section: Discussionmentioning

confidence: 99%

“…This explains the greater onset of lesions in photo-exposed body regions, mainly the head, neck, and face, and with advancing age. Among the photo-exposed areas, the scalp is one of the most frequently affected by cutaneous malignancies, and almost 16% of these are squamous cell carcinomas [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Management of Cutaneous Squamous Cell Carcinoma of the Scalp: An Algorithm for Reconstruction and Treatment

Rodio,

Tettamanzi,

Trignano

et al. 2024

JCM

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“…Squamous cell carcinoma (SCC), on the other hand, is the second most common type of skin cancer affecting the scalp and accounts for 16.6 % of all malignant scalp lesions [ 6 ]. SCC is a malignant invasive neoplasm that can potentially present with distant metastasis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The availability of microsurgical-free tissue transfers in resource-limited settings like ours has made aggressive scalp tumors amenable to radical treatment. Furthermore, few cases of sarcomas and invasive cutaneous squamous cell carcinoma of the scalp have been reported in the literature [ 5 , 6 ]. The authors present their successful experience using the anterolateral thigh flap with a titanium mesh for reconstructing full-thickness scalp defects as a safe and effective technique.…”

Section: Introductionmentioning

confidence: 99%

A staged approach for complex scalp defects using titanium mesh and anterolateral thigh flaps: Two case reports

Otieno,

Ouma,

Malik

et al. 2023

International Journal of Surgery Case Reports

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“…But once there is dural or brain invasion, the patient may develop neurological deficits, and the lesion may become inoperable. Dural involvement significantly reduces three-year survival from 83% to 22% [6]. Hence, the depth of invasion is a significant prognostic factor, and cranial involvement is associated with a poorer prognosis [7].…”

Section: Introductionmentioning

confidence: 99%

Squamous Cell Carcinoma Scalp With Intracranial Extension: Challenging Case of Multidisciplinary Care

Chirukandath¹,

Krishnan²,

Sulaiman³

et al. 2023

Cureus

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Squamous cell carcinoma (SCC) of the scalp is the second most common non-melanoma cancer of the skin. The incidence of squamous cell carcinoma on the scalp is on the rise, but the intracranial extension is rare. Cranial invasion is rare in SCC of the scalp, but when present, it is associated with a poor prognosis. A 62year-old female presented with complaints of swelling over the back of her scalp for three months, which rapidly increased in size. She also had a throbbing headache, alopecia in that area, and multiple episodes of pustules in that area. On examination, she had an ulceroproliferative lesion measuring 5*5*3 cm with an irregular surface and varying consistency over the occipital area in the midline surrounded by ulcerations and crusted discharge and fixed to the bone. Contrast-enhanced magnetic resonance imaging (MRI) showed an irregular lesion with the destruction of the right parietal and occipital bones involving both inner and outer tables with intracranial and extracranial components, and the lesion was abutting the superior sagittal sinus. The treatment is surgical resection of the tumor with margin clearance. The treatment plan was designed using a multidisciplinary approach with the collaboration of oncosurgery, neurosurgery, and plastic surgery. The patient underwent wide local excision of the tumor with adequate skin and cranial bone clearance. The tumor was found to have infiltrated the dura mater overlying the superior sagittal sinus. The defect was then closed using a vault prosthetic cover and a scalp transposition flap from the left parietal area. This case report intends to highlight the need for a multidisciplinary approach to the proper management of advanced squamous cell carcinoma to decrease the morbidity and mortality in patients.

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Invasive cutaneous squamous cell carcinoma of scalp: A case report

Cited by 3 publications

References 10 publications

Multidisciplinary Management of Cutaneous Squamous Cell Carcinoma of the Scalp: An Algorithm for Reconstruction and Treatment

Multidisciplinary Management of Cutaneous Squamous Cell Carcinoma of the Scalp: An Algorithm for Reconstruction and Treatment

A staged approach for complex scalp defects using titanium mesh and anterolateral thigh flaps: Two case reports

Squamous Cell Carcinoma Scalp With Intracranial Extension: Challenging Case of Multidisciplinary Care

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