A 57-year-old man had excision of a recurrent scalp squamous cell carcinoma and was scheduled for flap coverage of the defect when a firm, enlarged upper jugular cervical lymph node was noted (see neck masses folio). He was referred for further evaluation and treatment. Fine needle aspiration of the node revealed metastatic squamous cell carcinoma.
The patient was scheduled for wide excision, radical neck dissection and latissimus dorsi free flap coverage. The beginning of the reexcision is shown.
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