case_images: PMC5917313_01
case_images: Patient presentation with large open wound.
case_images: ICRP_A_1452615_F0001_C.jpg
case_images: PMC5917313_01_ICRP_A_1452615_F0001_C.jpg
case_images: F0001
case_images: A 76-year-old Caucasian man was referred to our institution for evaluation of a large open scalp wound, secondary to excision and prior radiation of squamous cell carcinoma (SCC) of the left temporal scalp (Figure 1).
case_images: Surgical excision and craniectomy.
case_images: ICRP_A_1452615_F0002_C.jpg
case_images: PMC5917313_01_ICRP_A_1452615_F0002_C.jpg
case_images: F0002
case_images: He underwent surgical excision of the defect, including craniectomy, due to apparent involvement of the dura (Figure 2).
case_images: Patient marked for harvest of left latissimus dorsi flap.
case_images: ICRP_A_1452615_F0003_C.jpg
case_images: PMC5917313_01_ICRP_A_1452615_F0003_C.jpg
case_images: F0003
case_images: A left latissimus dorsi myocutaneous flap was harvested for coverage of the defect (Figure 3).
case_images: Flap inset and coverage by full-thickness skin graft.
case_images: ICRP_A_1452615_F0004_C.jpg
case_images: PMC5917313_01_ICRP_A_1452615_F0004_C.jpg
case_images: F0004
case_images: The muscle flap was inset and the full-thickness skin graft, taken from the original donor site, was chosen to cover the free flap (Figure 4).
case_images: Pigmented lesion within central area of skin graft overlying the latissimus flap.
case_images: ICRP_A_1452615_F0005_C.jpg
case_images: PMC5917313_01_ICRP_A_1452615_F0005_C.jpg
case_images: F0005
case_images: Approximately 19 months following his free flap reconstruction, a pigmented lesion located centrally within the skin graft overlying the flap was discovered (Figure 5).