We describe a retired machinist who was 72 when first seen in our clinic. He developed squamous cell carcinoma in the intergluteal area which was resected elsewhere. About one year later, he developed a right groin mass. Biopsy showed metastatic squamous cell carcinoma.

At that point, he had no recurrence at the primary site. There was a firm right inguinal mass 8 cm. in diameter. It was draining purulent material. An extensive extent-of-disease work-up revealed no other evidence of cancer and he received an extended radical groin dissection. This entailed wide resection of the abdominal wall in the region of the involved lymph node. The wound was fully closed at a second stage and a skin graft was used.

He then received radiation therapy because of extracapsular spread. He did well for 30 months, then returned with discharge of intestinal contents from the incision. This was due to a herniated, perforated section of small bowel. A segmental resection of the involved bowel was done, leaving a large, full-thickness abdominal wall defect. This was closed with a bulky pedicled omental flap and resurfaced with a skin graft at a second stage. Five years after the radical groin dissection and 30+ months after the unorthodox abdominal wall reconstruction, the patient is free of cancer, has a stable abdominal wall and no hernia. He lives at home.