Non-Operable Squamous Cell Carcinoma of the Infraorbital Region Treated With Electrochemotherapy: A Case Report

Cutaneous squamous cell carcinoma (cSCC) is a malignant epithelial tumor of the skin, classified as a nonmelanoma skin cancer. It may develop from precancerous conditions such as chronic inflammatory dermatoses, actinic keratosis, or actinic cheilitis, but can also arise de novo. The aim of this case report is to describe the clinical management and therapeutic outcome of a patient with infraorbital squamous cell carcinoma who was deemed inoperable due to poor general health conditions, and was therefore treated with electrochemotherapy (ECT) as an alternative local therapy. A 73-year-old male patient with a complex medical history, including untreated chronic kidney disease, untreated diabetes mellitus, left leg lymphedema, right leg thrombosis, previous lobectomy for lung cancer, and amputation of the left big toe due to squamous cell carcinoma (SCC), presented with a new lesion diagnosed as SCC located in the infraorbital region. Electrochemotherapy is a minimally invasive oncologic treatment that combines electroporation with the administration of chemotherapeutic agents to enhance their cytotoxic efficacy. Bleomycin, 15 μ/m² (Bleomycin Nippon Kayaku, Sanofi Aventis, Milan, Italy), was administered intralesional before applying the electric pulses. After three sessions spaced two months apart, complete tumor remission was observed, as confirmed by PET-CT. Given the patient's complex comorbidities and inoperability, this report highlights the feasibility, safety, and effectiveness of ECT as a palliative and potentially curative local treatment option in anatomically and clinically challenging cases.