This case involves a 52-year-old woman who was treated annually by a dermatologist for lesions. Her dermatologist assessed the lesions on her neck as actinic, and she was treated with liquid nitrogen. Several months later, the lesion on the patient’s neck returned. The dermatologist sent for a biopsy which came back as squamous cell carcinoma. The lesion was treated with a topical anti-tumor medication and went away for about a year. The patient returned the following year to report a non-healing lesion on her neck. The dermatologist applied liquid nitrogen to the lesion and started the patient on an emollient cream. The patient returned 6 months later reporting that she was again having issues with the lesion. The dermatologist froze the lesion and advised the patient that she was fine. The next year, the patient presented for follow-up evaluation and the dermatologist set the patient up for a biopsy. The biopsy returned as stage IV malignant melanoma.