A recurrent squamous-cell carcinoma that was found clinically to have metastasized to regional lymph nodes was managed by a surgeon skilled in Mohs' techniques, a plastic surgeon, and a radiotherapist in a premeditated plan. The malignancy was further found to have extended to the base of the brain. As much surgery as was deemed feasible, still short of complete ablation of the malignancy, was performed. Radiotherapy to the neck prior to radical lymphadenectomy and to the base of the brain subsequently was administered. After one year of follow-up, the patient is well, though prognosis is guarded.