Cervical @entity3 of XXXX in an otherwise healthy @entity1 .

@entity5 @entity1 @entity189 @entity3
@entity189 is a rare cutaneous @entity5 characterized by slow but locally aggressive growth, which normally does not lead to systemic @entity3 . Frequent local recurrences are reported, which are most likely due to insufficient operative technique. We present the fourth case of cervical ipsilateral metastatic @entity189 in an otherwise healthy @entity1 . The @entity1 presented with a previously diagnosed but not completely resected @entity189 in the area of the right posterior scalp and two palpable ipsilateral lymph nodes. The @entity5 was resected using intraoperative snap frozen histological evaluation of the resection borders. In the same procedure two lymph nodes were resected from the right neck. The lymph nodes were histologically assessed and showed infiltration by small strains of @entity5 cells. After exclusion of a second @entity5 , e.g., @entity189 , as the cause for cervical lymph node @entity3 , we performed a modified radical neck dissection with resection of the sternocleidomastoid muscle and the accessory nerve, which was histologically proven to be perineurally infiltrated by @entity5 cells. In this second procedure the histological evaluation of the specimen showed no sign of remaining @entity5 infiltration. After exclusion of distant @entity3 the @entity1 was irradiated with 60 Gy. The @entity1 is well 1 year after the initial treatment without signs of recurrence.
