Basal Cell Carcinoma of Frontal Scalp. Pending Moh's Surgery. Had It 2x Before. Is This the Best Option?

Path. Report states: "islands of basaloid epithelium, characteriszed by peripheral palisading and single cell necrosis. .. Associated mucinous stromal alteration" What subclass is bcc? Help me determine best course for removal and cosmetic effect. (don't want bald spot) The tumor appeared suddenly, is about 2-3 cm. crusting, bleeds, scab...I have a history of basal and squamos cell...on face... and front chest. Family history too. Thanks for your help. Mag

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scalp basal cell carcinoma second round

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3 Doctor Answers | Asked by Mag in NJ

Doctor Answers (3)
Community Comments (3)

Mohs is absolutely indicated in a recurrent lesion on the scalp

Mohs is definitely indicated here. The pathology report does not indicate any thing more dangerous but the simple fact you have had two recurrences means the BCC needs more careful microscopic control of margins and this is where Mohs excels. Focus on the removal of the tumor first. Repairs come second. Often in large scalp cases your Mohs surgeon may get involved with a facial plastics or plastic surgeon to assist in closure. The scalp is pretty foregiving and... more

Steven Swengel, MD

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Los Gatos Dermatologic Surgeon

www.RefinedMD.com

Basal cell on scalp #skincancer

I do a few hundred of these closures a year for various Dermatologists here in Arizona. I can tell you that it is very unpredictable as to how big of an area will need to be removed. I do believe that for skin cancer in the head and neck area Mohs does offer the best choice for preserving skin for closure. Being that said, the scalp is very unforgiving and no surgeon could ever promise you that you will not lose an area of hair. It also depends on if the defect goes down to bone or not.... more

Reconstruction of Forehead Cancer Defect / Mohs Defect.

Sounds like Moh's surgery is a great option for you for the best chance at complete resection the first time. Closure by a board certified plastic surgeon would be important as the defect may be large. The forehead is a great donor site in skin cancer reconstruction of the face however when the forehead is involved the closure can be a bit more difficult. A skin graft is always an option but a A to T flap can provide an excellent result. To get the kind of movement you need general... more

Comments (3)

Mag in NJ 17 May 2013

My Mohs on my scalp worked out very well. Hair has returned and you can hardly see the scar. I am now getting checked by my dermatologist every 4-6 months... have had some "new" but not major issues in different places. Eyebrow, nose, hand. I used "f-udex 5%" on the brow and nose and I like the result... the process was easy. I tell everyone I can not to sit in the sun, use sun screen and get checked regularly. Thankx for your interest. Mag in NJ

Mag in NJ 25 Sep 2012

I had the Moh's surgery 1 week ago. All went well. The BCC was taken out in the first pass. However, the closure required more cutting so that a "good result" cosmetically could be achieved. So I have a 3 inch stitch line now... but the hair is already growing back. While there is no pain at the time of surgery it is a stressful process being awake while the doc's work. The closure took the most time (over an hour) I did have a plastic surgeon as well as my Moh's Doc plan the closure and do the work. I think the results will be more than fine. Even now I can do a comb over to cover the scar. I am not posting pics as they will make anyone fear far more than is needed... it all ends well. Thank you to the Doctors who responded to my quiry and of course I am grateful to the Doctors who did my surgery. If you live near Pa. Dr. Christopher Miller at U of P is wonderful. Written up as a "TOP DOC" in 2011. What they say about him is all true as I can attest to 3x over. Ma

Mag in NJ 24 Aug 2012

Thank you Doctor for responding to my concern. This is not a recurrence at the same site but I have had several other bcc and scc's on my face and collar bone. I have come to grips with the fact that I will have to have the procedure and hope for the best results. My Moh's Doc Dr. Miller of U of Penna. did a great job on my upper lip and along side my nose and under my eye. I had heard of some new "creams" which I was hoping might work but from what I have read... creams are out once it isn't precancer... or run the risk of recurrence. Thank you again. I will post after the procedure on 9/10. Mag

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