Management of a recurrence of a squamous cell carcinoma of the scalp with extension to the brain: A case report and literature review

Chabaane, Mohamed; Ayadi, Khalil; Rkhami, Mouna; Drissi, C.; Houimli, Sarra; Bahri, K.; Zammel, I.; Badri, Mohamed

doi:10.25259/sni_356_2020

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…Management of advanced SCC is challenging and often requires the collaboration of a multidisciplinary team to provide local and systemic treatment. 6,7 The current case report described advanced SCC of the scalp involving bones and meninges with brain exposure.…”

Section: Case Reportmentioning

confidence: 79%

Palliative Management of a Recurrent Destructive Cutaneous Squamous Cell Carcinoma of the Scalp With Brain Exposure

Fidanzi¹,

Davini²,

Dini³

et al. 2022

Wounds

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Introduction. Squamous cell carcinoma (SCC) is the second most prevalent malignant skin carcinoma. Bone infiltration is uncommon, and invasion of the dura mater and brain parenchyma is rare and possible only in the advanced stages of the disease. Treatment of advanced SCC is challenging and often requires the collaboration of a multidisciplinary team to provide local and systemic treatment. Management of advanced SCC of the scalp involving bones and meninges with brain exposure was described herein. Case Report. An 85-year-old male presented with advanced SCC of the scalp. A vegetative and infiltrating neoplastic ulcer of the frontal and parietal regions with exposure of the brain and extensive meningeal and bone destruction was observed. Because of comorbidities and decisions made by the patient and his family, he did not undergo immunotherapy, radiotherapy, or other invasive treatments. The neoplastic tissue was covered by blood, fibrin, and bacterial colonization. The patient received palliative care in a wound healing clinic twice monthly for 1 year, and daily dressing changes were performed at home. Binding bacteria dressings, silver dressings, and absorbent dressings were used to control exudate and infection. Alginate was used to manage bleeding, and charcoal dressings were used to manage odor. The dressings were covered with gauze and bandage. Additionally, swabs were performed when signs of infection were present and targeted systemic antibiotic treatment administered. Conclusions. Squamous cell carcinoma rarely presents with a devastating and rapid evolution. In this case, the local approach was based on the TIME (tissue, inflammation/infection, moisture imbalance, epithelial edge advancement) concept, with special attention paid to the most significant features of neoplastic wounds (eg, pain, exudate, bleeding, odor). Despite the patient’s serious conditions, he survived for a relatively long time.

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Section: Case Reportmentioning

confidence: 79%

Palliative Management of a Recurrent Destructive Cutaneous Squamous Cell Carcinoma of the Scalp With Brain Exposure

Fidanzi¹,

Davini²,

Dini³

et al. 2022

Wounds

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“…Once the bone defect is evaluated, we address the soft-tissue defects, including the skin, muscles, palate, and mucosal lining of the cheek. Finally, important structures such as the palate, oral commissure, nasal airways, and eyelids are addressed in an attempt to restore function and form, which is a real challenge, especially knowing that most of these patients will require post-operative radiotherapy 6,7,10 .…”

Section: Discussionmentioning

confidence: 99%

Squamous cell carcinoma in the malar region. Case report

Jiménez-Barrera,

Rodríguez-Vega,

Ruiz-Rodríguez

et al. 2024

GAMO

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“…The size of the defect, anatomic involvement, contour restoration, hairline maintenance, and return of soft-tissue bulk must all weigh in during the decision-making process. A multidisciplinary approach is essential for the management of tumors with intracranial extension, with assistance from neurosurgeons, plastic surgeons, and radiation oncologists for adjuvant radiotherapy [9].…”

Section: Discussionmentioning

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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Management of a recurrence of a squamous cell carcinoma of the scalp with extension to the brain: A case report and literature review

Cited by 7 publications

References 23 publications

Palliative Management of a Recurrent Destructive Cutaneous Squamous Cell Carcinoma of the Scalp With Brain Exposure

Palliative Management of a Recurrent Destructive Cutaneous Squamous Cell Carcinoma of the Scalp With Brain Exposure

Squamous cell carcinoma in the malar region. Case report

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

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