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Sciences approved this study (IR.SBMU.MSP. REC.1397.408).

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SCC arising in HS, whilst rare, has a mortality rate of 50.9%, owing to its aggressive nature and surgical complexity, 2 with a 48% recurrence rate following surgical excision. 4 This highlights the need to develop technology for enhancing the surgical approach in these difficult cases. The patient presented demonstrates how the clinically apparent margins can vastly underestimate the true extent of the SCC arising in HS and that the novel technique using MRI with electromagnetic navigation is a useful and accurate tool for defining tumour margins and guiding successful surgical excision. As such, it could offer patients the chance of relapse-free survival and potentially minimise the reliance on, and burden of, adjunctive cancer treatments.