Abstract
Squamous cell carcinomas developing on the scalp are often aggressive and may invade to the calvarium and through it to the dura mater. Wide excision is necessary and reconstruction may be challenging depending on the size and depth of the resulting defects.
A 62-year-old man, presented with a deep ulcerative neglected squamous cell carcinoma of the scalp extending to the underlying calvarium without lymph node involvement.
Wide excision of the lesion resulted in a composite soft tissue, bony, and dura mater defect. The dura was reconstructed with lyophilized bovine pericardium, the osseous calvarial defect with Medpor, while free anterolateral thigh flap was used to provide soft tissue cover.
The postoperative course was uneventful and the patient underwent adjunct radiotherapy two months postoperatively without any untoward sequelae. During a 5 year follow up the patient remains recurrence and metastasis free with a good cosmetic outcome.
Scalp reconstruction of composite defects resulting from oncologic resection with ALT free flap is an option providing reliable and durable coverage of the underlying reconstructed structures especially in view of future radiation therapy.
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Kakagia, D.D., Gravvanis, A. (2022). Composite Defect of Scalp and Calvarial Bone Following Oncological Resection. In: Gravvanis, A., Kakagia, D.D., Ramakrishnan, V. (eds) Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-23706-6_2
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DOI: https://doi.org/10.1007/978-3-030-23706-6_2
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