Excision of squamous cell carcinoma of forehead

By the time 77-year-old Mr Mack was admitted to the plastic surgery ward, the 10-week-old recurrent swelling on the right side of his forehead was about 6 cm in diameter and cystic in appearance. Histologically confirmed as a squamous cell carcinoma, the growth did not appear to be fixed to the underlying bone, but nor was it fully mobile which suggested that the malignancy may have spread to the deep fascia. Red and shiny on top, two or three discharging puncti were evident.