Brain Abscess Complicating Metastatic Scalp Basal Cell Carcinoma With a Malignant Fungating Wound: A Case Report and Literature Review.

Basal cell carcinoma (BCC), the most prevalent skin cancer, rarely metastasizes to the brain. Here, we report a case of a 63-year-old man with metastatic BCC complicated by a malignant fungating wound (MFW), a cancerous lesion seen in advanced diseases, and Staphylococcus aureus infection, resulting in brain abscesses and encephalopathy. The BCC initially involved the scalp and was treated with excision but later recurred and metastasized. It was associated with a chronic, open MFW lesion with necrosis and ulceration. MRIs revealed cranial structure involvement and brain abscesses. Despite treatment efforts, the patient's condition deteriorated, manifesting cognitive symptoms, ultimately leading to his placement in palliative care. Based on the findings of this case, vigilant monitoring, wound culturing of non-healing or necrotic, high-risk lesions to detect infections earlier, and appropriate palliative measures to manage MFWs may help improve patient outcomes.