AB124. SOH24AB_133. Diagnostic superiority of MRI in evaluating the presence of bone invasion in head and neck cutaneous squamous cell carcinoma
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AB124. SOH24AB_133. Diagnostic superiority of MRI in evaluating the presence of bone invasion in head and neck cutaneous squamous cell carcinoma

Conor Sheahan1, Ryan Sugrue2, Seamus Looby3, Stephen McNally2,4, Roisin Dolan2, Barry O’Sullivan2

1Medical School, The Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland; 3Department of Neuroradiology, Beaumont Hospital, Dublin, Ireland; 4Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland

Background: In cutaneous squamous cell carcinoma (cSCC) of the head and neck, accurate evaluation of bone invasion is imperative to guide ablative and reconstructive surgical planning and provide accurate pre-operative counselling for patients.

Methods: We present the case of an 88-year-old male with one year history of a poorly differentiated 8 cm × 6 cm ulcerated cSCC affecting the forehead.

Results: Computed tomography (CT) suggested direct adherence of the mass to the outer table of the frontal bone (FB). A magnetic resonance imaging (MRI) brain was performed to assess for invasion of the tumour into the adjacent critical structures. A Sagittal T1 post contrast MRI brain showed invasion through the outer table however the inner table was not breached and no adjacent critical structures were infiltrated. Tumour ablation and reconstruction was performed by a two team (plastic surgery and neurosurgery) approach. Final histology demonstrated infiltrative SCC involving the skin and underling bone. The radial margins were clear while bony margin was 1 mm from deep margin. At latest follow-up 2 years post procedure, the patient remains disease free.

Conclusions: CT provides a valuable initial assessment for patients presenting with cSCC of the head and neck. However, in cases of bony abutment on radiographs or clinically fixed masses, MRI is a superior imaging modality in accurately identifying the extent of bony invasion enabling procedural planning and patient consent.

Keywords: Cutaneous squamous cell carcinoma (cSCC); head and neck; neuroradiology; neurosurgery; plastic and reconstructive surgery

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab124
Cite this abstract as: Sheahan C, Sugrue R, Looby S, McNally S, Dolan R, O’Sullivan B. AB124. SOH24AB_133. Diagnostic superiority of MRI in evaluating the presence of bone invasion in head and neck cutaneous squamous cell carcinoma. Mesentery Peritoneum 2024;8:AB124.

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