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June 2004

A Rare, Rapidly Growing Purple Tumor on the Cheek—Quiz Case

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Arch Dermatol. 2004;140(6):751. doi:10.1001/archderm.140.6.751-b

A 40-year-old man presented with a 6-year history of a lesion on the upper part of his right cheek. The lesion had started as a skin-colored subcutaneous lump and had remained static for 5 years. Twelve months earlier, it started to enlarge and became raised above the skin surface. Six months earlier, it began to grow rapidly and turned purple (Figure 1). Palpation revealed a firm, rubbery, subcutaneous nodule with a more superficial protuberant lesion arising within it. The patient's general practitioner had clinically diagnosed a hemangioma because of its color and rapid growth phase. The lesion remained asymptomatic, and the patient had no systemic signs. The findings of an initial incisional biopsy were not helpful, only revealing a low-grade folliculitis. The lesion was then completely excised and sent for microscopic examination (Figure 2 and Figure 3)

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