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Outcomes of Cutaneous Squamous Cell Carcinomas Involving Scalp Periosteum: A Retrospective Review
Melissa M Rames1, Addison Demer2, Christian Baum2
1Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Objective:
To characterize patient demographics, tumor characteristics, treatment, and outcomes for a cohort of patients with cutaneous squamous cell carcinomas invading scalp periosteum.
Methods:
Electronic health records from our institution were queried to identify 27 patients and 28 tumors from 2011 to 2023.
Results:
Most tumors were poorly differentiated or spindled/sarcomatoid (60.8%, n=17) and Brigham and Women's Hospital/American Joint Committee on Cancer stage T2b/T3 (60.8%, n=17). All patients were treated with Mohs micrographic surgery (MMS). Seventeen patients (60.7%) received additional resection or procedures from other surgical services immediately following MMS; nine patients (32%) received adjuvant radiation, and five (18%) received adjuvant systemic therapy. The local recurrence rate was 3.6% (n=1). Five (17.9%) tumors progressed to metastatic disease (n=4 regional, n=1 distant) after an average follow up of 21.5 months.
Conclusion:
Patients with cutaneous squamous cell carcinoma involving scalp periosteum are at high risk for metastatic disease, but local control can be achieved with a multidisciplinary approach that includes MMS.
