A Case of Giant Squamous Cell Carcinoma of the Face Treated by Surgery Combined With Photodynamic Therapy

An 86-year-old woman presented with an 8 × 8 cm right facial mass exhibiting ulceration and exudation, later confirmed as moderately to poorly differentiated cutaneous squamous cell carcinoma (cSCC) with residual tumor cells post-surgery. Due to the tumor’s proximity to the orbit and her advanced age, wide local excision with a 6-mm margin was performed, though only 2–4 mm margins were achieved near the orbit. Postoperatively, three weekly sessions of photodynamic therapy (PDT) using 20% 5-aminolaevulinic acid were administered. Reconstruction was achieved via secondary intentional healing with moist dressings. By postoperative day 60, the wound had healed with minimal scarring, and no recurrence was observed at 6-month follow-up. This case illustrates that combining surgery, PDT, and secondary healing is a viable strategy for managing high-risk facial cSCC in elderly patients with challenging tumor locations. This integrated approach optimizes tumor clearance while preserving cosmetic outcomes.