RESUMEN
This study was conducted on ten patients with large scalp tumors Seven patients [70%] were advanced basal cell carcinoma eroding calvarium and reaching the dura matter in 2 patients. The other patients were sqamous cell carcinoma [30%]. Wide local excision was done with minimum safety margin [>/= 1cm] the eroded bones and dura mater was excised by neurosurgeon. Immediate reconstruction of the dura and bone was done using fascia lata and bone cement. Cutaneous coverage was achieved by free lattissimus dorsi in 3 patients. radial forearm flap in 1 patient, local bilobed and trilobed flaps in 5 patients and split-thickness skin graft in the remaining one. No flap loss occurred, infection occurred in 2 patients, gaping in one patient that required secondary procedure and donor site seroma in one patient. Mortality was 20% and recurrence in one patient. in spite of the relative risk of mortality and morbidity yet surgical excision offers the only remaining chance for those desperate patients with extensive tumors for whom no adjuvant measures are available. Those patients were always ready to get rid of offensive odor, repeated bleeding and disfigurement associated with the tumor