{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:09:13Z","timestamp":1787062153036,"version":"build-2736575974"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Malignant cancers arising in the scalp may exhibit calvarial invasion, dural extension, and rarely cerebral involvement. Typically, such lesions require a multidisciplinary approach involving both neurosurgery and plastic surgery for optimal resection and reconstruction. The authors present a retrospective analysis of patients with scalp malignancies who underwent resection and reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients presenting with scalp malignancies (1993\u20132021, n = 84) who required neurosurgical assistance for tumor resection were prospectively entered into a database. These data were retrospectively reviewed for this case series. The extent of neurosurgical resection was classified into four levels of involvement: scalp (level I), calvarial (level II), dural (level III), or intraparenchymal (level IV). Complications and evidence of local, locoregional, or regional recurrence were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Patients underwent level I (n = 2), level II (n = 61), level III (n = 13), and level IV (n = 8) resections. Pathologies consisted of primarily squamous cell carcinoma (n = 50, 59.5%), basal cell carcinoma (n = 11, 13.1%), and melanoma (n = 9, 10.7%), with infrequent lesions including sarcoma, atypical fibroxanthoma, and malignant fibrous histiocytoma. For cases requiring a cranioplasty, 92.2% were done using titanium mesh and 7.8% with methylmethacrylate. At a mean follow-up of 35.5 \u00b1 45.9 months, the overall survival was 48.8% (n = 41) and recurrence-free survival was 31.0% (n = 43). Scalp-based reconstruction involving plastic surgery was performed in 75 (89.3%) patients. The most commonly used free flap was a latissimus dorsi muscle flap (n = 46, 61.3%). One or more postoperative complications occurred in 21.4% of all patients, the most common being wound dehiscence or delayed wound healing in 13% (n = 11).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>A multidisciplinary approach with aggressive neurosurgical resection is associated with good outcomes in patients with primary malignant scalp tumors, despite invasive disease on presentation. This analysis suggests that aggressive resection (level II and higher) is effective at reducing locoregional recurrence and is not associated with a higher risk of complications relative to resection without craniectomy. As most patients require scalp reconstruction to close the postresection defect, usually with vascularized free tissue transfer, involving a plastic surgeon in the surgical planning and execution is essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.7.jns23974","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T23:44:32Z","timestamp":1696031072000},"page":"979-986","source":"Crossref","is-referenced-by-count":4,"title":["Malignant primary tumors of scalp with cranial extension: multidisciplinary surgical strategies and outcomes"],"prefix":"10.3171","volume":"140","author":[{"given":"Kristin M.","family":"Huntoon","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory R.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Ascension Texas Spine and Scoliosis, Austin, Texas;"},{"name":"Department of Neurosurgery, The University of Texas at Austin, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel K.","family":"Fahim","sequence":"additional","affiliation":[{"name":"Spine & Brain Surgery Specialists, Royal Oak, Michigan; and"},{"name":"Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Rochester, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saloni","family":"Kumar","sequence":"additional","affiliation":[{"name":"Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Adelman","sequence":"additional","affiliation":[{"name":"Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian E.","family":"McCutcheon","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Am J Clin Dermatol","first-page":"233","article-title":"Primary and metastatic malignant tumors of the scalp: an update","volume":"11","author":"Richmond HM","year":"2010","unstructured":"Richmond HM, Duvic M, Macfarlane DF. Primary and metastatic malignant tumors of the scalp: an update. Am J Clin Dermatol. 2010;11(4):233\u2013246."},{"issue":"1","key":"b2","series-title":"J Surg Oper Care","first-page":"103","article-title":"Malignant scalp tumors: retrospective analysis of 1000 patients","volume":"7","author":"Corradino B","year":"2022","unstructured":"Corradino B, Di Lorenzo S, Carmisciano M, Corradino A. Malignant scalp tumors: retrospective analysis of 1000 patients. J Surg Oper Care. 2022;7(1):103."},{"issue":"3","key":"b3","series-title":"J Am Acad Dermatol","first-page":"448","article-title":"Malignant cutaneous tumors of the scalp: a study of demographic characteristics and histologic distributions of 398 Taiwanese patients","volume":"56","author":"Chiu CS","year":"2007","unstructured":"Chiu CS, Lin CY, Kuo TT,  Malignant cutaneous tumors of the scalp: a study of demographic characteristics and histologic distributions of 398 Taiwanese patients. 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