Adjuvant radiotherapy in high-risk cutaneous squamous cell cancer of the head and neck in immunosuppressed patients Shlomo A. Koyfman, MD, Nikhil Joshi,

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Adjuvant radiotherapy in high-risk cutaneous squamous cell cancer of the head and neck in immunosuppressed patients Shlomo A. Koyfman, MD, Nikhil Joshi, MD, Allison Vidimos, MD JAAD Case Reports Volume 1, Issue 6, Pages S5-S7 (November 2015) DOI: 10.1016/j.jdcr.2015.09.016 Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A, Pre-auricular mass with overlying erythema. B, Axial section on contrast CT scan shows a 3.2- × 0.9- × 1.9-cm plaquelike soft tissue density of heterogeneous attenuation within the cutaneous and subcutaneous fat overlying and contiguous with the underlying right parotid gland and masseter muscle without distinct invasion. No lymphadenopathy was seen. C, Photomicrograph shows several peripheral nerve trunks with perineural carcinoma. An associated lymphocytic inflammatory infiltrate surrounding the perineurium is present. D, Axial (left panel) and coronal (right panel) sections on radiation planning CT scan show the high-dose planning target volume (in red) and low-dose planning target volume in blue. Isodose lines are depicted with 6000 cGy prescription line covering the high-dose target and the 5400 cGy line covering the elective nodal target. The high-dose target includes branches of the facial nerve as they track back toward the stylomastoid foramen. There is excellent sparing of intracranial and midline organs at risk. (C, Hematoxylin-eosin stain; original magnification: ×12.) JAAD Case Reports 2015 1, S5-S7DOI: (10.1016/j.jdcr.2015.09.016) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions