Adenoid cystic carcinoma of the scalp

Few cases of adenoid cystic carcinoma of the scalp have been described in the literature. Herein, we report a new case illustrating the difficulties of diagnosis and treatment of this rare form of tumour. A 49-year-old man consulted for a large ulcerated scalp tumour. The biopsy sample exhibited an aspect of cystic adenoid carcinoma. Bone invasion had occurred. Extremely wide surgical excision was carried out, extending down to the dura mater, with covering by means of a frontal flap with left temporal pedicle. Since the edges of the resection were also tumoural, postoperative radiotherapy at 56Gy was given. Twelve months later, the patient was still in remission. The standard treatment for adenoid cystic carcinoma is complete surgical excision but this approach may be complicated by difficulties relating to the degree of tumour spread or to the anatomical site. Postoperative radiotherapy appears to improve local control, as illustrated by our case.