INVASIVE SKINCARCINOMA OF THE SKULLTREATED WITH A ROTATIONALFLAP-A CASE REPORT

Abstract

The escalating incidence of skin malignancies, particularly in sun-exposed areas such as the head and neck, requiresinnovative approaches for challenging cases. Squamous cell carcinoma, though common, rarelyinfiltrates the skull, presenting unique challenges in treatment and reconstruction.In this case report, we describethe management of a 77-year-old patient with recurrent invasive squamous cell carcinomaof the left temporal region extending into the skull. The patient underwent three surgeries within our institution due to squamous cell carcinomarecurrence, leading to a complex skin defect unsuitable for conventional closure methods.Ourapproach involved the use of a local rotational flap, usingthe robust vascularity of the scalp, allowing versatile orientation relative to the defect. The operating techniqueconsisted of a craniectomy, removal of infiltrated tissue, and affected dura, followed by plastic reconstruction of the skin with a rotational flap, preserving healthy periosteum and temporal fascia.As the population with cutaneous neoplasms ages, the demand for expeditious and less morbid reconstructive options grows. This case underlinesthe effectiveness of the local rotational flap for reconstructing medium-sized complex scalp defects post-cancer resection. Our experience suggests that the rotational scalp flap is a reliable and safe choice, offering a favorable balance between surgical outcomes and patient well-being.