Kerathoacanthoma (KA) and Squamous cell carcinomas (SCC) are entities that often have been difficult to differentiate. Current thought establishes that Kerathoacanthoma behave similarly to a low-grade squamous cell tumors. We present a case of an 80 year old female which history of present illness as well as clinical impression mimics Kerathocacnathoma (KA), but on histopathological examination resulted in Squamous Cell Carcinoma (SCC). We posit the use of novel histopathological and cytological advances, such as TGF-β sequencing and TGF-Alpha staining in assessing the specimen. Subtle differences should guide treatment for patients that need further resection and that might have orbital involvement.
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