case_images: PMC1314891_01
case_images: 63 year old male patient presenting with a large 8 x 8 cm measuring exulcerated suppurating tumor of the scalp (Marjolin's ulcer).
case_images: 1471-2407-5-150-1.jpg
case_images: PMC1314891_01_1471-2407-5-150-1.jpg
case_images: F1
case_images: A 63 year old male patient presented with a large 8 x 8 cm ulcerated and suppurating tumour of the scalp (Fig. 1).
case_images: Nuclear magnetic resonance imaging revealing tumor infiltration of the cranium and frontal cortex.
case_images: 1471-2407-5-150-2.jpg
case_images: PMC1314891_01_1471-2407-5-150-2.jpg
case_images: F2
case_images: Nuclear magnetic resonance and computed tomography imaging revealed a tumour with infiltration of the cranium and the brain (Fig. 2).
case_images: Four weeks postoperative aspect of donor site at left forearm.
case_images: 1471-2407-5-150-3.jpg
case_images: PMC1314891_01_1471-2407-5-150-3.jpg
case_images: F3
case_images: The donor site was covered with a split thickness skin graft from the thigh (Fig. 3).
case_images: Uncomplicated healing of radial forearm flap on left hemicranium.
case_images: 1471-2407-5-150-4.jpg
case_images: PMC1314891_01_1471-2407-5-150-4.jpg
case_images: F4
case_images: Postoperative healing was uneventful and the patient regained his speech immediately after the operation (Fig. 4).
case_images: Six weeks after primary resection tumor relapse with multiple satellite metastases around the radial forearm flap.
case_images: 1471-2407-5-150-5.jpg
case_images: PMC1314891_01_1471-2407-5-150-5.jpg
case_images: F5
case_images: Six weeks later, the patient was referred to our unit again with multiple satellite nodules around the radial forearm free flap (Fig. 5).
case_images: Secondary wide resection and closure of defect with a skin grafted latissimus dorsi myocutaneous flap consecutively connected to the former radial artery and vein of the primary flap.
case_images: 1471-2407-5-150-6.jpg
case_images: PMC1314891_01_1471-2407-5-150-6.jpg
case_images: F6
case_images: After the second operation postoperative healing was uneventful again, and the patient recovered well initially for the first three weeks (Fig. 6 and 7).
case_images: Uneventful early postoperative course after second free flap with uncomplicated donor site and no impairment of shoulder function.
case_images: 1471-2407-5-150-7.jpg
case_images: PMC1314891_01_1471-2407-5-150-7.jpg
case_images: F7
case_images: After the second operation postoperative healing was uneventful again, and the patient recovered well initially for the first three weeks (Fig. 6 and 7).