Squamous cell carcinoma of the scalp with intracranial extension – the importance of various imaging modalities

Srdjan Stošić; Mirela Juković; Jagoš Golubović; Milana  Panjković; Sanja Stojanović

doi:10.2298/VSP210226100S

Srdjan Stošić University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia
Mirela Juković University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia
Jagoš Golubović University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Milana Panjković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Sanja Stojanović University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP210226100S

Keywords: diagnosis, histological techniques, immunohistochemistry, magnetic resonance imaging, neoplasm invasiveness, neoplasms, squamous cell, neurosurgical procedures, scalp

Abstract

Introduction. Around 2% of all cutaneous neoplasms arise in the scalp and can be classified as either primary or metastatic. The intracranial extension is rare in cutaneous malignancies but can generally occur if left untreated. Squamous cell carcinoma (SCC) is the second most common type of nonmelanoma skin cancer after basal cell carcinoma. About 3–8% of SCCs are located on the scalp and can cause skull and dural invasion in rare cases. Case report. A 49-year-old male patient presented with a large and painful lesion in the parietooccipital region of the head. Magnetic resonance imaging (MRI) revealed a large inhomogeneous, necrotic lesion with infiltration of the underlying skull and dura. The patient underwent surgical removal of the tumor with excision of invaded skin, bone, and dura with a safety margin of 1 cm, followed by custom prefabricated 3D-printed cranioplasty with polymethylmetacrilate. Pathohistological analysis revealed invasive SCC with immunohistochemistry staining revealing CK5/6 and CK7 positivity. Conclusion. Some cases of scalp SCCs can cause invasion of the underlying skull and dura if left untreated. Imaging modalities like computed tomography (CT) and MRI play a crucial role in evaluating the degree of neoplastic extension and potential calvarial and dural invasion, thus being of significant importance in preoperative planning and management.

Author Biography

Srdjan Stošić, University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia

dr med.

Centar za radiologiju

Klinički centar Vojvodine

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