Skull Base 2011; 21(6): 343-350
DOI: 10.1055/s-0031-1284216

© Thieme Medical Publishers

Skull Base Surgery for the Management of Deeply Invasive Scalp Cancer

Paul James Donald1 , James Boggan2 , D. Gregory Farwell1 , Danny J. Enepekides3
  • 1Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California
  • 2Department of Neurosurgery, University of California, Davis, Sacramento, California
  • 3Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
Further Information

Publication History

Publication Date:
31 August 2011 (eFirst)


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.