Primary malignant tumors of the scalp may arise from any elements which comprise epithelial, glandular or somatic tissue. Generally, these malignant timors have unique characteristics different from that of other skin cancers found elsewhere. Because of the hairs, detection is often delayed and because of so many unannoying benign skin lesions in the scalp, patients occasionally do not ask for early medical care. However, if appropriate treatment is deferred, tumors may fatally invade adjacent calvarial bone or underlying brain, and reconstruction method is not simple which requires intact bony vault and hairy skin. Authors have experie-..ced 7 cases of basal cell carcinoma, 12 cases of squamous cell carcinoma, 4 cases of malignant melanoma. Except inoperable one case that tumor invades occipital lobe and sagittal sinus, we have performed radical excision and reconstruction which are divided by the following groups according to the depth of invasion.
In Group A, radical excision was done on the subgaleal plane and reconstruction is performed with use of local flaps.
In Group B, outer table of calvarial bone was removed and scalp was reconstructed with local flaps and skin graft.
In Group C, full layer of calvarial bone was removed and cranium was reconstructed with autogenous calvarial bone or rib bone and scalp was reconstructed with local flaps or myocutaneous flap and skin graft.
In Group D, neurosurgical excision was added.
We have perfomed above surgical treatment in 22 cases with satisfactory results and we will present our cases with brief review of literatures.
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