Anaplastic large cell lymphoma (ALCL) is characterized by proliferation of anaplastic large CD 30+ T-cell lymphoid cells with abundant cytoplasm. Primary cutaneous ALCL is a rare form of ALCL, usually seen in elderly patients. In this report, the authors present an unusual case of 15-year-old boy with a solitary left ear lobe mass, previously reported as keratoacanthoma which was later histopathologically and immunohistochemically diagnosed as T-cell phenotype, anaplastic lymphoma kinase (ALK)-negative primary cutaneous anaplastic large cell lymphoma. The patient's response to chemotherapy was good and he is receiving the continuation phases of his chemotherapy.