A 79-year-old male presented to dermatologist with a large ulcerative lesion on clavicle; he reported lesion first appeared 5 months ago while living in Florida for the winter
Diagnosed with localized cutaneous squamous cell carcinoma
Standard surgical excision performed with 4 mm clinical margins; postoperative margins negative
May 2018
Patient returns to dermatologist for follow-up c/o multiple lesions on shoulder and neck around the site of prior excision
PE:
Multiple visible, ulcerated lesions, approximately 2-3cm in diameter; suspected tumor depth >5mm
Multiple palpable nodes ~2cm
Imaging confirmed 7 mm invasion into subcutaneous fat; parotid nodal involvement