When would you offer adjuvant chemotherapy after axillary dissection and RT for an isolated squamous cell carcinoma of an axillary node with unknown primary?  

This is a conundrum that is rare but real. Here are my recommendations: Make sure an extensive medical history is taken about potential lesions that were frozen, excised, etc. Speak with your pathologist to make sure the SCC is not originating from a pilar tumor, or similar adnexal skin appendag...