A 73-year-old healthy white man was seen with a 2.8 × 1.5-cm pearly plaque on the left postauricular region. A shave biopsy specimen revealed a basal cell carcinoma, which was treated successfully with Mohs micrographic surgery. All other cutaneous examination findings were unremarkable except for a soft, pulsating mass measuring approximately 4 cm on the scalp vertex (Figure 1A). A bruit could be heard on direct auscultation. The patient denied a history of trauma to the area and denied any neurologic, vision, or hearing disturbances.