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March 1, 2026Cureus0 citationsOpen Access

Keratinizing Squamous Cell Carcinoma Masquerading as Basal Cell Carcinoma Constituting a Diagnostic Pitfall: A Case Report With Etiopathogenetic Discourse and Mohs Micrographic Surgical Management

SSSanjoy SanyalRARachel AndrewDGDelia Graham-Durand

Key Points

  • This case report aims to highlight the diagnostic challenges in distinguishing between keratinizing squamous cell carcinoma and basal cell carcinoma.
  • Case report detailing the clinical presentation and surgical management of a misdiagnosed skin cancer.
  • Utilized Mohs micrographic surgery for tumor removal while preserving surrounding healthy tissue.
  • Analyzed etiological and environmental factors relating to skin cancer diagnosis, with a focus on Fitzpatrick skin types and UV radiation.
  • The initial diagnosis of basal cell carcinoma was incorrect; the tumor was confirmed as squamous cell carcinoma upon surgical intervention.
  • Mohs micrographic surgery achieved complete tumor removal with minimal scarring.
  • Emphasized the critical need for awareness about diagnostic pitfalls to improve early detection and treatment success.

Abstract

Among non-melanoma skin cancers of the face, basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) are the most common. They are close differentials of each other and often constitute diagnostic pitfalls during assessment. This is a case report of the diagnosis and Mohs surgical management of an SCC that was initially clinically diagnosed as BCC. Mohs micrographic surgery (MMS) for cancers of cosmetically sensitive areas such as the face has proved to be a very useful procedure for ensuring 100% tumor removal with maximum normal tissue-sparing. This case report also analyzes the etiological, environmental, and demographic factors that lead to skin cancers of the face, with emphasis on the relationship of Fitzpatrick skin types and ultraviolet (UV) solar radiation vis-à-vis their propensity to cause skin cancers. High index of suspicion followed by early intervention still remains the hallmark of early, accurate diagnosis of skin cancers of the face, with the aim of ensuring high cure rates and minimum facial disfigurements. A case series of this type with longer follow-ups will alleviate the limitations of this case report.

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Cite This Study

Sanyal et al. (2026) studied this question.

synapsesocial.com/papers/69a3d867ec16d51705d2f356https://doi.org/10.7759/cureus.104371
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