A case of squamous cell carcinoma (SCC) with regional lymph node metastasis in a 69-year-old Japanese man is reported. The tumor was characterized by the proliferation of peripheral basaloid, inner squamoid, and glycogen-rich cells, the presence of trichilemmal keratinization, and the presence of ladder-like, membrane-coating granules. These findings suggested that this tumor differentiates toward a hair-follicle structure. The most interesting feature of this tumor was the presence of medusa head-like granules in the cytoplasm of the clear squamoid cells adjacent to the keratinized cells. We have been unable to find any other studies of these granules in squamous cell carcinoma.