A Rare Head and Neck Tumor: Making Simple Things Complicated

Primary cutaneous anaplastic large cell lymphoma (ALCL) is a very uncommon type of CD30-positive T-cell lymphoma, and it very rarely affects the forehead. We report the case of a 68-year-old male presenting with an ulcerative lesion on the right forehead, initially suspected as a benign condition. Fine needle aspiration suggested a lymphoproliferative disorder, with biopsy and immunohistochemistry confirming primary cutaneous ALCL (CD30-positive, anaplastic lymphoma kinase [ALK]-negative). The patient was treated with a standardized chemotherapy regimen and achieved a complete response. This case underscores the importance of considering primary cutaneous ALCL in the differential diagnosis of persistent ulcerative lesions in anatomically sensitive areas. Early diagnosis, multidisciplinary management, and advanced therapeutic strategies such as Brentuximab Vedotin + Cyclophosphamide, Hydroxyrubicin, and Prednisone (BV + CHP) are critical to optimizing outcomes in this rare presentation.