An 80-year-old white man with a remote history of melanoma and a history of multiple basal cell carcinomas presented with a large, asymptomatic, friable tumor overlying the left side of the mandible. He reported that the tumor had been rapidly growing over the last 4 months. His medical history included atrial fibrillation, chronic pain syndrome, and cervical spondylosis.
Physical examination revealed a 4.0 × 1.5-cm, exophytic, ulcerated, pearly, pinkish red, nontender telangiectatic tumor on the skin overlying the left side of the mandible (Figure 1 and Figure 2). There was no evidence of lymphadenopathy. A diagnostic biopsy specimen was obtained (Figure 3 and Figure 4).