This report describes the case of a 97-year-old male patient, completely dependent on his activities of daily living (ECOG 3), with a 6-month-old tumor lesion in the anterior area of the chest. Skin biopsy informs a trichilemmal carcinoma. The patient received 5 weekly radiotherapy sessions of 7 Gy each (35 Gy total), with partial tumor response. It is intended to apply new sessions of radiotherapy to the affected area. The case is presented due to the low prevalenceand the dermoscopy findings of this type of carcinoma associated with a partial response to radiotherapy, a treatment rarely reported as first-line for this pathology.