Table 1. Clinical timeline for Case 1 and Case 2.

SSG, split thickness skin grafting

Case	Event	Timeline	Details
Case 1	Onset of tumor	14 years ago	Progressive scalp tumors neglected due to geographic isolation and social factors
	Initial presentation	After 14 years	26 × 22 cm fungating mass diagnosed as invasive squamous cell carcinoma
	Diagnostic imaging	Upon presentation	CT showed skull invasion; PET scan showed no distant metastasis
	First surgery	Day 1	En bloc resection with local flap reconstruction and SSG over the scalp
	Second surgery - Stage 1	Day 14	First stage of radial forearm pedicled flap reconstruction
	Second surgery - Stage 2	Day 35	Detachment of radial forearm pedicled flap and SSG over the forearm donor site
	Postoperative radiotherapy	Three months post-op	Adjuvant therapy completed
	Follow-up	12 months post-op	Disease-free with no recurrence
Case 2	Onset of tumor	Four years ago	Recurrent lesion after prior benign tumor excision
	Initial presentation	After four years	22 × 20 cm fungating mass diagnosed as undifferentiated pleomorphic sarcoma
	Diagnostic imaging	Upon presentation	CT revealed skull and sagittal sinus invasion; no metastasis was detected
	Surgery	Day 1	Wide local resection with neurosurgical assistance; local flap and skin graft reconstruction
	Follow-up	Ongoing	Regular monitoring for recurrence