Complex Scalp and Calvarium Defects After Giant Basal Cell Carcinoma Excision: Management, Challanges, Outcomes

Area of Science:

• Oncology
• Neurosurgery
• Plastic Surgery

Background:

• Giant basal cell carcinoma (GBCC) is defined as a tumor ≥5 cm in diameter.
• GBCC of the scalp often necessitates extensive resection involving soft tissues, calvarium, and dura.

Purpose of the Study:

• To evaluate single-stage reconstruction methods for GBCC of the head.
• To discuss reconstruction techniques, cerebrospinal fluid (CSF) leakage, hospital stay duration, and tumor recurrence.

Main Methods:

• Retrospective analysis of 5 patients with GBCC of the head undergoing single-stage scalp, calvarium, and dural reconstruction (2010-2017).
• Evaluation of reconstruction methods, defect areas, CSF leakage, hospital stay, and tumor recurrence.
• Calvarium reconstruction utilized either titanium mesh or methyl methacrylate.

Main Results:

• Average hospital stay was 15 days.
• Titanium mesh was used in 3 patients; methyl methacrylate in 2.
• Cerebrospinal fluid leakage occurred in patients reconstructed with titanium mesh.
• Tumor recurrence near the calvarium was observed in one patient reconstructed with methyl methacrylate.

Conclusions:

• Single-stage reconstruction is feasible for complex GBCC of the head.
• The choice of calvarium reconstruction material may influence outcomes like CSF leakage and hospital stay duration.
• Titanium mesh reconstruction may be linked to a longer hospital stay and CSF leakage, warranting further investigation.