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Pre-operative view of the lesion.
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A 71-year-old patient was referred to our unit for an aggressive squamous cell carcinoma of the scalp in the parieto-mastoid area (Figure 1).
Intraoperative view after the neurosurgical removal of the lesion.
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The dural plane was intact, and a minute neoplastic spot infiltrating the transverse sinus was evident and left in situ (Figure 2).
Latissimus dorsi muscular free flap anastomosis.
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Anastomoses were performed between the subscapular artery and the superior thyroid artery and between the subscapular vein and the external jugular vein (Figure 3).
One year after the surgery, clinical progression of the disease was evident.
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One year after the surgery, following the clinical progression of the disease (Figure 4), radiation therapy was exclusively indicated with concomitant cemiplimab therapy.
Two-year follow up. No residual evidence of disease nor recurrence is reported.
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At a two-year follow up the patient is still free from disease (Figure 5).