Page 142 - Clinical relevance of current materials for cranial implants
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                                Chapter 7
MATERIAL AND METHOD
Case
An 82-year-old Caucasian fair skinned male visited the department of Head and Neck Surgery and Oncology with complaints of an itchy and tender red, scaling and non- healing skin of the scalp since four months.
The patient had undergone multiple surgical procedures for a cutaneous squamous cell carcinoma of the scalp, after which he underwent external beam radiation therapy (20 x 3 Gy) two years prior to presentation because of a recurrent lesion. Furthermore, the medical history of the patient included hypertension and Waldenstrom macroglobulinaemia.
At physical examination a crusted and ulcerated lesion with a diameter of approximately 7 cm was observed. Centrally of the ulceration the tabula externa was visible. (Figure 1) The principal clinical diagnosis was osteoradionecrosis of the skull, however biopsy demonstrated a recurrent cSCC.
Figure 1: Clinical presentation of the ulcerated and crusted lesion on the scalp with a diameter of 7 cm and centrally exposure of the underlying cranial bone.
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