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A Case for Diagnosis. Presented by Dr. Chris R. Halloran.
Mr. H. W., a 64 year old white man, states that a "birth mark" appeared on the lateral aspect of the right shoulder ten years ago; the lesion was flesh colored when it first appeared. Three years ago he brushed against a wall and injured the lesion. Since that time there has been a slowly growing ulcer at the site of the former "birth mark."
At present, the lateral aspect of the right shoulder presents a quarter-sized lesion, the margins of which appear atrophic. The center of the lesion is a nickel-sized area of what appears to be granulation tissue. No biopsy or other laboratory examinations have yet been made.
DISCUSSION
Dr. Saul Robinson: My diagnosis is epithelioma, probably a mixed type, both basal and squamous cell. I think therapy should be removal of the entire lesion with a cautery.