A man, 64 years of age, retired and resident on the Spanish Mediterranean coast, without family or personal history of cutaneous tumours, requested primary medical evaluation for a lesion that had been present for a year. The lesion was located on his left ear, and had been growing progressively, without irritation, pain or other significant symptoms. No loss of weight or appetite was present.
Physical examination revealed a 2 cm exophytic mass with yellowish coloration on the top edge of the ear, with a hyperkeratotic surface and erythematous and infiltrated base. No cervical, submandibular or supraclavicular nodes were found on palpation. The remainder of the examination did not reveal any other abnormalities.
The patient was referred to a hospital dermatology department with the clinical diagnosis of cutaneous horn. Biopsy of a fragment of 0.3 cm of skin was taken. Histology was reported as squamous cell carcinoma. A chest X-ray did not reveal any abnormalities. The patient underwent surgical excision of the lesion by wedge resection of the involved helix. Histology revealed that the lesion had been fully excised with appropriate tumour free surgical margins. On follow up, no clinical relapses were detected after 2 years.
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