Case 1: Ticket clip excision

Authors: Frederik Gulmark Hansen, med.stud. and Magnus Balslev Avnstorp, MD

84 year old male with an aggressive ulcerating squamous cell carcinoma on the helical rim of the right ear.

Before and after

Step 1: Pre operative photo

Ulcerating squamous cell carcinoma on the helical rim of the right ear

Step 2: Drawing

Drawing is made in a 7.5 mm margin

Step 3: Excision

Excised in 7.5 mm margin including chondral parts, using per-operative histology freezing assessment.

Step 4: Re-Excision

Excised in further 3 mm until the borders were histologically verified free of cancer.

Step 5: Closure

Due to the size of the excision defect it was not possible to adapt the upper and lower part of the remaining ear. Instead the skin was closed over the chondral parts to avoid necrosis of these.

Step 6: Follow-up

Patient was seen at 3 months follow-up in the outpatient clinic. No sign of recurrent carcinoma.