A 40-year-old man presented with a 4-month history of a nontender, nonpruritic papule on the left side of his chin. He reported that it reappeared each time he shaved it off with his razor. He had no personal or family history of skin cancer and denied having had any similar lesions in the past. He had a 7-year history of sacrococcygeal chordoma. At the time of his initial diagnosis of chordoma in 1996, he had been treated with surgical excision and postoperative radiation therapy. His disease progressed in the ensuing years to involve multiple sites in the thoracic and lumbar spine, pelvis, sternum, clavicles, lungs, and liver. He had recently completed his first cycle of vinorelbine tartrate chemotherapy, after having undergone previous treatment with paclitaxel, ifosfamide, and hyperthermia.
Dubroff RP, Maki RG, Busam KJ, Sachs DL. Bluish Papule in a Middle-aged Man—Quiz Case. Arch Dermatol. 2005;141(12):1595-1600. doi:10.1001/archderm.141.12.1595-b