A 43‐year‐old patient with a history of squamous cell carcinoma (SCC) of the lip, multiple actinic keratoses, and multiple sequential SCC on sun‐exposed areas of his skin developed a subcutaneous nodule of SCC in an area where a cutaneous SCC had been excised 1 year previously. At the time of the subcutaneous nodule there was no evidence of metastases; 5 months later he had metastatic bone disease as well as apparent metastases to myocardium, pericardium, and pleura. The patient is notable for the young age at primary diagnosis of SCC, the fulminant lethal course of a tumor which is generally considered curable, and a family history to which SCC occurred over three generations.