BACKGROUND Pseudoepitheliomatous hyperplasia (PEH) is a reactive epithelial proliferation occurring secondary to infection, neoplasm, injury, and inflammation. The histopathological characteristics of PEH may lead to it being confused with well-differentiated squamous cell carcinoma (SCC). CASE REPORT We present here the case of a 57-year-old male patient, who was diabetic and a smoker, who presented with dysphonia. Although nasal endoscopy suggested SCC, morphological and immunophenotypical study of biopsy tissue ruled out malignancy. CONCLUSIONS As the prognosis worsened, the patient required several urgent surgical interventions due to bleeding abscesses and dyspnea. A total laryngectomy was performed.