Pathologically proven right buccal mucosal space squamous cell carcinoma, underwent wide local excision with supraclavicular artery island flap (SCAIF) and right supraomohyoid block neck dissection.

Histological examination:

Papillomatous tumor proliferation lined by hyperplastic atypical stratified squamous epithelial cells with dysplastic features, hyperkeratosis, and heavy lymphoplasmacytic infiltrate at the base.

Diagnosis: Verrucous carcinoma.

Free all surgical margins all around.

Negative for lymphovascular emboli and perineural invasion.

Free salivary gland tissue and 23 lymph nodes.