Faculty Bibliography

The case of a patient with a basal-cell carcinoma over a clavicle that escaped early treatment and became widespreadand deeply burrowing is recounted. It was first treated by radiotherapy, seemed to have been cured thereby, but two years later showed recurrence. It was then treated by Mohs' fresh-tissue technique which cleared the skin but exposed invaded bone and uncertain depth of involvement below. Radical extirpative surgery was subsequently attempted on two occasions, but when invasion was found to have involved major vessels in the neck, further treatment had to be abandoned. Some lessons of the case are discussed

A recurrent squamous-cell carcinoma that was found clinically to have metastasized to regional lymph nodes was managed by a surgeon skilled in Moh's techniques, a plastic surgeon, and a radiotherapist in a premeditated plan. The malignancy was further found to have extended to the base of the brain. As much surgery as was deemed feasible, still short of complete ablation of the malignancy, was performed. Radiotherapy to the neck prior to radical lymphadenectomy and to the base of the brain subsequently was administered. After one year of follow-up, the patient is well, though prognosis is guarded