Tumours of the Scalp: A Review of Ten Cases

Background: The scalp is a common site for the development of tumours. Most of these tumours are benign; among the malignant ones, squamous cell carcinoma (SCC)) and basal cell carcinoma (BCC) predominate. In Ghana patients with scalp tumours do not report to hospital unless they are symptomatic. Data on the condition is therefore scanty. Patients and Methods: The objective of the study was to document the hospital prevalence and the management outcome of patients with scalp tumours. Patients with tumours of the scalp reporting at the Reconstructive Plastic Surgery and Burns Unit (RPSBU) at Komfo Anokye Teaching Hospital (KATH) who were managed by the author between June 2003 and June 2009 were entered into the study. The patients were examined clinically and the diagnosis confirmed by biopsy. The scalp tumours were excised and the defect closed directly, skin grafted, or repaired with a flap as appropriate. Results: Ten patients with eleven scalp tumours were managed during the study period from June 2003 to June 2009, made up of four males and six females. Their ages ranged from 16 to 70 years, with a mean age of 41.7 years. Two benign scalp tumours, a sebaceous cyst and a sebeceoma were located in the frontal region; five cases of SCC and one case of basosquamous cell carcinoma (BSC) in the parietal region, two cases of SCC in the temporal region, and one case of SCC in the occipital region of the scalp. Eight of the tumours developed de novo from the scalp; one developed from a chronic burn scar (Marjolin’s ulcer); two tumours developed from the scalp of a patient with xeroderma pigmentosum. Two patients had excision and direct closure of the defect; six had excision and skin grafting; two had excision and flap repair. One patient had block dissection of the left cervical lymph nodes, and two patients had adjuvant radiotherapy. Conclusions: Most tumours of the scalp presenting at the RPSBU at KATH are SCC which developed de novo. Chronic burn scars and xeroderma pigmentosum were some of the aetiological factors identified. Early lesions can be cured by excision and skin grafting.