663 Squamous Cell Carcinoma of the Scalp Following Synthetic Hair Transplantation: A Case Report

Abstract

Androgenetic alopecia is the most common form of hair loss. Surgical treatment options include autologous and synthetic hair transplantation. Synthetic hair fibres can overcome the challenges of poor hair quality and density however there are reports of severe cutaneous complications following their use.

We report a case of an advanced squamous cell carcinoma (SCC) of the scalp in an adult male patient following chronic artificial hair transplants. The fungating mass eroded the inner cortex of the left parietal bone without intra-cranial extension on CT. Indeterminate lymph nodes in the parotid gland and level III of the left neck were identified on CT and MRI. Resection of the artificial hair fibres and SCC with a craniectomy, total parotidectomy with facial nerve preservation and upper neck dissection were performed. There was extensive dural involvement not detected on pre-operative imaging, which involved the superior sagittal sinus and was unresectable. The dural disease was fulgurated. The defect was reconstructed with a titanium plate and DIEP flap. Final histopathology showed a moderately differentiated pT4a N0 M0 SCC. The patient received adjuvant proton beam therapy and at 18 months post-operatively is recurrence free.

Development of scalp SCC following synthetic hair transplantation has been described, although a clear causation has not been defined. Clinicians should be aware of this presentation and aim to achieve an early diagnosis, timely referral to an appropriate specialist and prompt management.