This case involves a female patient who presented to a dermatology facility because of two suspicious spots that appeared on her face. One of the lesions was determined to be cancerous, and the dermatologist performed a Mohs microsurgery on one of the dark spots. The other spot was not considered to be problematic, according to the initial slides sampled, and no surgery was performed at that site. One year after the procedure, the patient presented to the dermatologist for a follow-up visit. At this time, additional slides were taken of the remaining spot, which resulted in a diagnosis of cancer. Upon further evaluation, it proved to be a very aggressive and invasive mass. The patient had to have her eye removed and subsequently died shortly thereafter from metastatic disease.