Hostname: page-component-7bb8b95d7b-5mhkq Total loading time: 0 Render date: 2024-09-11T09:36:26.588Z Has data issue: false hasContentIssue false

Intracranial Invasion of a Basal Cell Carcinoma of the Scalp

Published online by Cambridge University Press:  02 December 2014

David Mathieu
Affiliation:
Department of Neurosurgery/Neuro-Oncology, Centre Hospitalier Universitaire de Sherbrooke, Universite de Sherbrooke, Sherbrooke, Canada
David Fortin*
Affiliation:
Department of Neurosurgery/Neuro-Oncology, Centre Hospitalier Universitaire de Sherbrooke, Universite de Sherbrooke, Sherbrooke, Canada
*
Centre Hospitalier Universitaire de Sherbrooke (CHUS), 3001 12e avenue Nord, Sherbrooke, Quebec J1H 5N4 Canada
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective and importance:

Basal cell carcinomas are common lesions that can have a locally invasive behavior. The authors present a case of a scalp lesion with skull and dura-mater invasion that was unrecognized prior to surgical undertaking.

Clinical presentation:

A 66-year-old female presented with an extensive ulcerating lesion on the frontal scalp, deemed to be a basal cell carcinoma. The plastic surgery team brought her to the operating room for resection but subsequently backed off after the discovery of bony invasion. Imaging revealed extensive bony and epidural extension.

Intervention:

Resection of the invaded frontal scalp, bone, dura-mater and proximal part of the superior sagittal sinus was performed. This was followed by a reconstructive procedure consisting of a duraplasty, a cranioplasty, and a skin rotation flap and partial-thickness skin grafting.

Conclusion:

Radiological evaluation of scalp basal cell carcinomas should be done prior to surgery to rule out any bony or intracranial invasion.

Résumé:

RÉSUMÉ:Objectif et importance:

Le carcinome basocellulaire est une lésion fréquente dans laquelle on peut observer un envahissement local. Les auteurs présentent un cas de lésion du cuir chevelu avec envahissement du crâne et de la dure-mère qui n’avait pas été soupçonné avant la chirurgie.

Observation clinique:

Une patiente âgée de 66 ans a consulté pour une ulcération importante à la région frontale du cuir chevelu chez qui on a posé un diagnostic de carcinome basocellulaire. L’équipe de chirurgie plastique a interrompu l’exérèse de la lésion après avoir constaté en salle d’opération son extension à l’os. L’imagerie a montré une extension importante de la tumeur à l’os et à la dure-mère.

Intervention:

On a procédé à une résection de la région envahie par la tumeur au niveau du cuir chevelu, de l’os, de la dure-mère et de la partie proximale du sinus longitudinal supérieur. Par la suite, la patiente a subi une chirurgie de reconstruction, soit une dura plastie, une cranioplastie et la mise en place d’un lambeau cutané de rotation ainsi que d’un greffon de peau mince.

Conclusion:

On devrait procéder à une évaluation radiologique des carcinomes basocellulaires du cuir chevelu avant la chirurgie pour éliminer la possibilité qu’il existe un envahissement osseux ou intracrânien.

Type
Case Report
Copyright
Copyright © The Canadian Journal of Neurological 2005

References

1. Wong, CSM, Strange, RC, Lear, JT, Basal cell carcinoma. BMJ 2003; 327:794798.Google Scholar
2. Gall, C, Buttner, A, Bise, K, Steiger, HJ. Primary intracranialmetatypical basal cell carcinoma: case report. Neurosurgery 1997; 41:279282.Google Scholar
3. Miller, DL, Weinstock, MA. Nonmelanoma skin cancer in the UnitedStates: incidence. J Am Acad Dermatol 1994; 30:774778.Google Scholar
4. Marks, R, Staples, M, Giles, G. Trends in non-melanocytic skin cancertreated in Australia: the second national survey. Int J Cancer 1993; 53:585590.Google Scholar
5. Lasso, JM, Garcia-Tutor, E, Bazan, A. Aggressive basal cell carcinomaof the temporal region in a patient with Gorlin-Gotz syndrome. Ann Plast Surg 2000; 44:429434.Google Scholar
6. Takemoto, S, Fukamizu, H, Yamanaka, K, et al. Giant basal cellcarcinoma: improvement in the quality of life after extensive resection. Scand J Plast Reconstr Surg Hand Surg 2003; 37:181185.Google Scholar
7. Veness, MJ, Biankin, S. Perineural spread leading to orbital invasionfrom skin cancer. Australas Radiol 2000; 44:296302.Google Scholar
8. Schroeder, M, Kestlmeier, R, Schlegel, J, Trappe, AE. Extensivecerebral invasion of a basal cell carcinoma of the scalp. Eur J Surg Oncol 2001; 27:510511.Google Scholar
9. Parizel, PM, Dirix, L, Van den Weyngaert, D, et al. Deep CerebralInvasion by Basal Cell Carcinoma of the Scalp. Neuroradiology 1996; 38:575577.Google Scholar
10. Long, SD, Kuhn, MJ, Wynstra, JH. Intracranial extension of basal cellcarcinoma of the scalp. Comput Med Imaging Graph 1993; 17:469471.Google Scholar
11. Ko, CB, Walton, S, Keczkes, K. Extensive and fatal basal cellcarcinoma: a report of three cases. Br J Dermatol 1992; 127:164167.Google Scholar