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The picture below is of a 67 yr-old male who presented with an ulcerated mass overlying the right parotid gland and facial nerve paralysis of the marginal, buccal and temporal branches on the right side.

 

He had a history of a small basal cell carcinoma resected in the same area 3 years prior. Subsequent discussion with the plastic surgeon who did the original biopsy revealed that the patient was negligent in follow-up despite numerous letters and phone calls from the plastics office.

 

CT scan- diffuse infiltrative process involving both lobes of the parotid gland, facial nerve and extension to the right skull base.

 

Biopsy confirmed suspicion for diffusely infiltrative basal cell carcinoma.

 

Bccaear1.jpg

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He really didn't give one, but then again I don't think he was late for his MENSA meeting either.......a portion of the population we treat hear in NW PA is "backcountry" for lack of a better explanation. How one of his family members didn't pressure him to do something about it is beyond me though. It isn't like this happened overnight, even though he tried to say it had only been there a month......

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