Descriptive Analysis of Clinical spectrum and Operative Outcome of Scalp Tumors in a Regional Neurosurgical Centre
Aliyu M. Koko and Ali Lasseini
Backgrounds: Scalp tumors are uncommon and complex conditions seen by neurosurgeons requiring multi-disciplinary approach in their management. Both benign and malignant lesions could involve the scalp but data on clinical spectrum and outcome of surgical intervention are few to aid management guidelines and possibly improve outcome and quality of life of individuals affected by scalp tumors. This study was designed to unravel the spectrum and operative outcome of scalp tumours in our neurosurgical centre. Methods: A retrospective analysis of all cases of scalp tumours managed in our centre from January 2020 through December 2021. Results: We found thirty-eight cases over the study period, males represent the majority (57.9%), with a male-female ratio of 1.4:1. The mean age of presentation was 20 years. Benign tumours account for 63.1% (24/38). The most common benign tumour was dermoid cyst followed by lipoma and plexiform neurofibroma. Primary malignant scalp tumours were commoner than metastasis (21.0% and 15.7% respectively). Fibrosarcoma top the list of primary malignant tumours while metastatic follicular carcinoma remains the most frequent secondary scalp tumour. Benign tumors were all operated as day case while malignant had complete gross total excision. Late presentation (six month after the appearance of the mass) was common to all but two benign cases. 57% of malignant tumors presented with ulcerated lesion requiring control of infection which further delayed surgical intervention, with average presentation-intervention interval of 30 days. Only one case of malignant tumour had completed radiotherapy, some declined (2/14) while others could not have it due to financial constraint. All cases of malignancy were lost to follow-up with three representing with recurrence (7.8%) Two post-operative mortalities were recorded (5.2%). Conclusion: Benign scalp tumour represents about two-third of all scalp tumours. Primary malignant scalp tumours were commoner than metastasis. Outcome was generally fair with 5.2% mortality observed.