Squamous cell carcinoma of the scalp with intracranial extension - the importance of various imaging modalities

Introduction. Around 2% of all cutaneous neoplasms arise in the scalp and can be classified as either primary or metastatic. The intracranial extension is rare in cuta-neous malignancies but can generally occur if left un-treated. Squamous cell carcinoma (SCC) is the second most common type of nonmelanoma skin cancer after basal cell carcinoma. About 3-8% of SCCs are located on the scalp and can cause skull and dural invasion in ra-re cases. Case report. A 49-year-old male patient pre-sented with a large and painful lesion in the parietooccip-ital region of the head. Magnetic resonance imaging (MRI) revealed a large inhomogeneous, necrotic lesion with infiltration of the underlying skull and dura. The pa-tient underwent surgical removal of the tumor with exci-sion of invaded skin, bone, and dura with a safety margin of 1 cm, followed by custom prefabricated 3D -printed cranioplasty with polymethylmetacrilate. Pathohistologi-cal analysis revealed invasive SCC with immunohisto-chemistry staining revealing CK5/6 and CK7 positivity. Conclusion. Some cases of scalp SCCs can cause inva-sion of the underlying skull and dura if left untreated. Imaging modalities like computed tomography (CT) and MRI play a crucial role in evaluating the degree of neo-plastic extension and potential calvarial and dural inva-sion, thus being of significant importance in preoperative planning and management.