Dermatologist Misdiagnoses Squamous Cell Carcinoma

Case Overview

This case takes place in New Jersey and involves a Mohs procedure. After the procedure, the patient developed what the dermatologist thought was a cyst. The dermatologist lysed the cyst, but did not send the biopsy to pathology. He was prescribed antibiotics and given a steroid injection. Months later, the patient was referred by the dermatologist to an ENT who found her ear canal to be swollen shut. He referred the patient to an ENT specialist who ordered and emergent CT, ultrasound, and biopsy. It was positive for invasive squamous cell carcinoma. The patient was referred to another hospital where she underwent numerous surgical procedures. The patient was immunocompromised and on Gleevec when the Moh’s procedure was performed. This physician had been following the periauricular area in the past and was aware of his immunocompromised state.

Questions to the Dermatology expert and their responses

Do you routinely perform MOHS surgery?

I have performed Mohs surgery for over 25 years and I have published and lectured extensively on Mohs surgery.

Do you have experience with patients like the one described in this case?

Immunosuppressed patients are at higher risks of spread and metastatic disease from squamous cell carcinomas.

Have you ever had a patient develop this outcome?

I have never had a patient develop this outcome and have never been the target of a malpractice claim.

Have you ever served as an expert witness?

I have testified as an expert witness numerous times regarding medical malpractice related to the MOHs procedure.

About the expert

This board certified dermatologist holds membership in the nation's most prestigious dermatological societies, and has published more than 10 articles and papers in the field. She received her B.A. in human biology from Stanford University, her M.S. in biological sciences from Stanford University, and her M.D. from University of Vermont School of Medicine. This expert completed her internship in internal medicine at the University of Kansas School of Medicine, and her residency in dermatology at the University of Kansas School of Medicine. She is the former chief resident at the University of Kansas Medical Center's Division of Dermatology, and is currently an assistant professor in dermatology and an associate director of the dermatological division at one of the nation's top university medical center's dermatology programs.