We present a rare case of squamous cell carcinoma that arose deeply in the abdominal wall, 10 years after abdominal dermolipectomy and wall repair by dermal-adipose graft was performed. The patient presented a 10-cm-diameter subcutaneous tumor that was ulcerated on its superficial aspect, adherent to deep tissues. After histologic examination, we tried to remove the neoplastic mass in a radical way. The surgical defect was repaired with a bilateral tensor fasciae latae flap. The extension, aggressiveness, and deep localization of the malignancy led to the patient's death. In this article, we also analyze a different hypothesis about the origin of squamous cell deep carcinomas and the related literature.