The combined multidisciplinary approach to invasive basal cell tumors of the scalp.

Deeply invading tumors of the scalp present numerous extirpative and reconstructive problems requiring the combined expertise and skills of both medical and surgical disciplines. We have employed a combined multidisciplinary approach to recurrent tumors of the scalp and calvarium. Intraoperatively, a fresh-tissue mapping modification of Mohs' histographic surgical technique is performed on the entire surgical specimen. This allows for total microscopic margin control of a recurrent basal cell carcinoma during a single surgical procedure. The resulting defect is immediately reconstructed by myocutaneous free flap transfer using microvascular techniques.