Histological Patterns and Management Options in Malignant Tumors of Scalp

ABSTRACT

Introduction: The scalp is the most frequent site of occurrence of malignant tumors because this area is generally neglected bythe patient and not closely monitored during physical examinations, scalp tumors can go unnoticed until they become malignant.Aim: The aim of our study was to analyze the histological patterns and management options in malignant tumors of the scalp.Materials and Methods: This prospective study was conducted to analyze the histological pattern and management options inmalignant tumors of the scalp. Medical reports of patients diagnosed with the clinical diagnosis of scalp lesions were studied.H&E stained slides of the scalp lesions were retrieved and reviewed. Clinical and histopathological diagnoses were studiedfor each case to evaluate clinically misdiagnosed cases. Data so obtained were tabulated and were analyzed statistically, andresults were discussed.Results: Out of 25 cases, male patients were 13 (52%) and female patients were 12 (48%), age distribution ranges from 20 to80 years with <30 years 2 patients (8%), 31–40 years 4 patients (16%), 41–50 years 3 patients (12%), 51–60 years 9 patients(36%), >61 years 7 patients (28%), based on histological pattern squamous cell carcinoma is most common of 10 cases (40%),basal cell carcinoma 8 cases (32%), dermatofibrosarcoma 2 cases (8%), fibroxanthoma 1 case (4%), melanoma 2 cases (8%),and metastatic tumors 2 cases (8%) where the primary site is the lung in both the cases. Sixteen cases (64%) were managedby split skin graft, 7 cases (28%) by rotational/transpositional flap, and 2 cases (8%) by free flap.Conclusion: Although malignant scalp tumors are not common, when facing a patient with scalp lesions or lumps, physiciansshould be alert in detecting any suggestive new growth hidden in this hairy area to make an early diagnosis and perhaps todetect primary cancer in case of metastatic scalp tumors.