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.