Spinocellular cancer is the second most common form of skin cancer, is caused by the cumulative exposure of skin to UV light. It is frequently found in phototype 1 and 2 individuals and has a prevalence in Caucasian groups of 100/100,000.inhabitants (female sex) and 150/100,000 inhabitants(male sex), being much lower in the black groups 3/100,000; OR=33-50 times higher in the white race. 87-year-old man, a former smoker of about 20 cigarettes daily. Farmer with prolonged exposure to sunlight for many years. Hypertension. Chronic atrial fibrillation. In pharmacological treatment with antihypertensives and cardioaspirin. Already operated on the right temporal region for a squamous cell carcinoma two years earlier. For about two months the lesion has reappeared. for which it was decided to carry out complete excision of the lesion by biopsy, Therefore, it was decided to perform complete excision of the lesion for biopsy. The presence of a poorly differentiated non-keratinizing squamous cell carcinoma without border involvement was reported. Patient evolves favorably without relapses. The next definition of the biopsy Despite achieving a complete resection of the lesion, it presents a poor prognostic characteristic that is poorly differentiated morphology, which accompanies others such as: a thickness of the tumor > 2 mm, level IV or V invasion Clark's, perineural invasion, primary site on the ear or lip. In atypical cases, a detailed histopathological study by specialists with experience in oncology is required to rule out suspicious lesions and provide adequate and timely treatment. In oncology, the most recommended is to carry out a multidisciplinary management to deliver the best personalized therapeutic option. It is very important in cases like these to carry out a histological study of suspicious lesions to rule out malignant tumors and provide adequate treatment. It is essential to have an adequate biopsy in order to be able to define pure surgical management versus surgical management with concomitant radiotherapy with electrons, ideally depending on the requirements and means of each center, that is, IMRT (modulated intensity) teletherapy machines.