Squamous cell carcinoma of the nape
This woman came to the hospital with an ulcerated bleeding mass on the back of the head, skin biopsy revealed a squamous cell carcinoma. This patient reported having tried alternative "medicine" to treat a small mass that she noticed, she only came to the hospital when the mass was extraordinarily big and the remedies she had been given didn't work (obviously weren't going to work). By the time she sought medical attention her carcinoma had already grown to dispropotionate dimensions and was invading the back of the skull. Due to its size and invasion it can't be surgically excised and due to its location and extension radiotherapy is not recommended. Not needed to say this has a very poor prognosis.
She should be treated in paliative care and could benefit from systemic chemotherapy, the current guideline being a platinum/taxane (e.g. cisplatin + paclitaxel) combination and a third drug of choice. Though radiotherapy is not recommended she could also benefit from low dose brachytherapy or radiotherapy to reduce tumour size. Experimental treatment with Cemiplimab could also prove benefitial. Even with proper treatment and response prognosis remains poor
Not sure there's any way to treat this. Excision is impossible, and radiotherapy would, at best, slow progression. This person needs palliative care.
more advanced head and neck cancer is best managed surgically, providing the tumour is resectable, with postoperative radiotherapy for poor prognostic situations
