Advanced Periorbital Squamous Cell Carcinoma Complicated by Extensive Facial Myiasis in a Homeless Patient: A Case Report

Facial myiasis is an uncommon but severe complication associated with neglected malignant lesions, particularly in socially vulnerable patients. Squamous cell carcinoma (SCC) of the facial region may exhibit aggressive local behavior when diagnosis and treatment are delayed. The authors report a rare case of extensive facial myiasis associated with infiltrative periorbital SCC in a homeless patient. A 57-year-old man presented with a large ulcerated periorbital lesion and active infestation. Emergency management included blood transfusion, systemic ivermectin, and surgical debridement with mechanical removal of larvae under general anesthesia. Histopathology confirmed moderately differentiated SCC. Despite initial clinical improvement, the patient abandoned follow-up. This case highlights the importance of prompt surgical intervention and the impact of social determinants on disease progression and treatment outcomes.