ulcero-proliferative lesions over scalp vertex. They had undergone excision of the lesion twice in last 3 years followed by primary closure in the case 2 and excision followed by split skin graft (SSG) in the case 1. Both developed recurrence of lesion within 3 months of each surgery. Biopsy performed during the surgery was consistent with DFSP scalp. The tumors underwent extensive ulceration 3 months before reporting to us. On examination, the lesions were painless, hard and nodular, which

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... on touch [ Figure 1 ]. Ulcers were found fixed to the underlying bone with presence of granulation tissue and wound discharge. No significant cervical lymphadenopathy was observed. Central nervous system examination was normal. Ultrasonography abdomen and chest X-ray were done to rule out likely areas of secondaries. Computed tomography (CT) showed an extensive soft-tissue lesion involving all the scalp layers over the scalp vertex with involvement of the underlying bone. Lesion also involved the previous SSG in case 1. Both outer and inner table of calvarium were involved with intact dura [ Figure 2 ]. Wide excision of the lesion, including the previous SSG was planned keeping a margin of 5 cm. Full thickness excision of the involved bone was done with 3 cm margin.