SURGICAL REMOVAL OF A SKIN-CANCER INVOLVING THE SUPERIOR SAGITTAL SINUS - GRADUAL OBSTRUCTION OF THE SINUS USING MINIATURE TISSUE EXPANDERS

An extensive basal cell carcinoma of the mid-parietal scalp penetratin g the skull and invading the posterior third of the superior sagittal sinus was successfully treated in a 60-year-old man. This was accompli shed by gradually obstructing the sinus over a period of five weeks un it it was possible to resect the tumor along with 15 cm of the sagitta l sinus. Total obstruction of the sinus was achieved using two miniatu re tissue expanders surgically placed and affixed to the vessel. By gr adual filling of the expanders, it was possible, after five weeks, to demonstrate angiographically that the sagittal sinus between the two t issue expanders was obliterated. The one piece resection included a wi de margin of skin, bone, dura mater and sagittal sinus. The extensive defect of the dura mater was covered by a free fascia lata graft and t he scalp defect by a visor bipedicled forehead flap. The forehead dono r area was skin grafted. There were no complications during surgery an d the patient recovered uneventfully. There has been no recurrence aft er one year.