We report recurrent basal cell carcinoma of the scalp with deep cerebr
al invasion in an 82-year-old man. Plain films and CT showed extensive
, full thickness, skull destruction at the vertex. Gadolinium-enhanced
MRI revealed neoplastic invasion of the meninges and left cerebral he
misphere, down to the lateral ventricle. We postulate that tumour exte
nded into the brain along perivascular spaces of transcerebral vessels
. This hypothesis is supported by the cleft-like contrast enhancement
on MRI.