Treatment of cutaneous XXXX of the head and neck.

@entity1 @entity5426 @entity5
A total of six @entity1 with cutaneous @entity5426 involving the head and neck were treated during the period 1985-1994. The distribution of sites between the scalp and the rest of the head and neck was equal. Initial local treatment involved surgery for four @entity1 and radiotherapy for two @entity1 . In the surgical group, following seemingly adequate macroscopic surgical excision, all four @entity1 had inadequate surgical margins on histology. Five of six @entity1 had disease recurrence within the head and neck and of these a further three went on to have a second episode of recurrence. Median time to recurrence was 8 months. All cases were misdiagnosed clinically at initial presentation and three of six had initial inconclusive histology. @entity5426 of the head and neck is an aggressive @entity5 . Radiotherapy offers the only real chance of obtaining adequate local control even if surgical excision is carried out. Radiotherapy must encompass wide fields and whole scalp irradiation is mandatory for scalp lesions. A combination of laterally opposed photon and electron fields provides a simple, quick and effective means to deliver a tumoricidal dose of 50 Gy to the whole scalp with minimal irradiation of the underlying brain.
