title: The management of non-melanocytic skin malignancies of the scalp and calvarium.
abstract: BACKGROUND
  The management of advanced cutaneous malignancies has been controversial. Thirteen patients with nonmelanoma skin neoplasias that had invaded the bone of the calvarium and scalp were treated in our centre.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate our experience in treating these malignancies with scalp resection and full or partial thickness cranium reconstruction.
  
  
  METHODS
  From June 2008 to March 2012, thirteen patients with locally advanced tumours of the scalp invading the calvarium were treated with wide local excision of the scalp combined with an underlying craniectomy and dural resection if needed.
  
  
  RESULTS
  Using histopathological diagnosis eleven patients were diagnosed with basal cell carcinoma and two patients with squamous cell carcinoma. A full thickness cranium resection was performed in seven patients and partial in six patients.
  
  
  CONCLUSIONS
  These large cancers occasionally invade adjacent structures, as well as bone, presenting a challenging surgical problem. In general, giant rotational or island scalp flaps and free tissue transfers are needed to close the area. Finding clean margins are an important part of treating patients with bone involvement and can usually be attained using outer tabula curettage thus preventing unnecessary morbidity.
authors.affiliation: Plastic and Reconstructive Surgery Clinic, Faculty of Medicine, Baskent University, Ankara, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Cöloğlu
authors.affiliation: Plastic and Reconstructive Surgery Clinic, Faculty of Medicine, Baskent University, Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Ozkan
authors.affiliation: Anesthesiology Clinic, Faculty of Medicine, Baskent University, Adana, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Sener
authors.affiliation: Plastic and Reconstructive Surgery Clinic, Faculty of Medicine, Baskent University, Ankara, Turkey.
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Uysal
authors.affiliation: Plastic and Reconstructive Surgery Clinic, Faculty of Medicine, Baskent University, Ankara, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Borman
keywords: Bone invasion; calvarium; non-melanocytic; reconstruction; scalp; skin malignancies