Abstract: An 88-year-old male presented with a single dark-brown skin mass on the top of the head for 10 years, with enlargement and ulceration for 1 year. Physical examination showed a 10.2 cm×7.1 cm mass on the top of the head, with irregular shape, clear boundary, irregular edge and bulging nodular hyperplasia, crater ulcer in the center and uneven bottom. The histopathology features were in accordance with trichothecal carcinoma. The patient was treated with surgical excision, with no recurrence after 6-month follow up.