2019 Volume 33 Issue 3 Pages 244-249
A 60-year-old woman was first reported to have a lesion on her head around 2008 ; several years later, she was referred to our department because of a suspected malignant tumor ; however, she did not visit us. In 2015, she visited our department for the first time with a chief complaint of bleeding from the lesion. An irregular lesion accompanied by easy bruising and an odor were observed, extending from the patient's parietal region to the forehead. The lesion showed a self-destructive tendency ; a part of the crown was recessed, the dura mater was exposed, and an arterial pulse was palpable. The pathological findings indicated squamous cell carcinoma. Lymph node and distant metastases were not observed on imaging examinations. Magnetic resonance imaging revealed parietal bone destruction and cranial infiltration. The patient was diagnosed with a stage IV (T4N0M0) lesion. She was treated with radiotherapy and docetaxel/cisplatin/5-fluorouracil (TPF) chemotherapy after resecting maximum tumor possible. After 5 courses of TPF therapy were administered, brain invasion was observed, and the patient was judged to have a progressive disease. Disease progression was subsequently halted when the chemotherapy was changed to gemcitabine/paclitaxel. A random biopsy of the ulcer remaining in the parietal region was performed after 5 courses of gemcitabine/paclitaxel therapy was administered, and the absence of tumor cells was confirmed. Thereafter, debridement and divisional grafting surgery was performed. We compared the present case with other cases of squamous cell carcinoma with intracranial invasion in Japan.[Skin Cancer (Japan) 2018 ; 33 : 244-249]
