Table 1. Timeline of interventions and outcomes.

Timeline	Medical history and past interventions
	No family history of skin cancer 1999: total gastrectomy for gastric adenocarcinoma
	Diagnostic testing and interventions
Past Interventions 2013 – 2017	2000: Patient reports onset of nodular skin lesion 2013: Incisional biopsy: BCC CT scan (23-Jan-2013): high local burden of disease (5.0cm AP diameter), with destructive osteo-muscular infiltration     -    vismodegib 150mg daily from Feb to Nov-2013 2014: relapse of nodular skin lesion Excision biopsy (Feb-2014): SCC Wide surgical excision (22-May-2014): not radical Adjuvant chemotherapy:     -    cisplatinum/fluorouracil for 3 cycles, Aug – Sep-2014     -    radio-chemotherapy with gemcitabine Dec-2014 – Jan-2015     -    cisplatinum/docetaxel Aug-2016 – Nov-2016     -    gemcitabine monotherapy for 8 cycles Dec-2016 – Jul-2017
31-Jan-2018	Baseline assessment	Immunohistochemistry: low/no PD-L1 expression CT scan (31-Jan-2018): 6.2cm AP diameter
19-Apr-2018	Initiation of therapy	-    cetuximab initial single dose of 400mg/m2, then 250mg/m2 weekly
6 weeks	Reassessment	CT scan (28-May-2018): 7.2cm AP diameter     -    cetuximab 250mg/m2 every two weeks
12 weeks	Final outcome	CT scan (12-July-2018): 7.0cm AP diameter     -    cetuximab 250mg/m2 every two weeks

AP, anterior-posterior; BCC, basal cell carcinoma; CT, computerized tomography; SCC, squamous cell carcinoma; PD-L1, programmed cell death ligand-1.