Well-differentiated squamous cell carcinoma of the eyelid arising during a20-year period

An 81-year-old man had a keratotic eyelid lesions for 20 years. He eventual ly sought treatment by ophthalmic plastic surgery. Clinically, the lesion r esembled a keratoacanthoma. Findings from histologic examination of the exc ision biopsy specimen showed a squamous cell carcinoma. The lesion was comp letely excised. This case demonstrates the difficulty in making a correct c linical diagnosis of a keratotic eyelid lesion. Performing a histologic exa mination of nonregressed keratotic lesions is essential to exclude a squamo us cell carcinoma.