Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers, with an increasing incidence worldwide. Chronic sun exposure is a major risk factor and lesions are usually seen on sun-exposed areas such as the face, neck, scalp, and hands. Imiquimod cream, an immune response modifier, has shown promising results in the management of SCC.

A 70-year-old, Filipino male presented with 3-year history of a slow growing erythematous plaque on the abdomen. Physical examinaPon done showed a solitary, well- defined, erythematous plaque measuring 5cm on the leR lower quadrant of the abdomen. Histopathologic examination revealed SCC. In an initial attempt to decrease the size of the tumor, Imiquimod 5% cream 2x a week was initiated. However with continuous use for 24 weeks the patient achieved complete clinical resolution which was confirmed with biopsy.

This case report showcases imiquimod cream as a valuable therapeutic option for giant (5cm)cutaneous squamous cell carcinoma, offering a non-surgical alternative with promising outcomes. This treatment approach has the potential to expand the management options for cSCC and benefit patients who may not be suitable candidates for conventional surgical excision.