An 89-year-old man presented with a lesion on the left temple. For the past several years, the patient had experienced multiple benign actinic lesions of his face and scalp that would slough off. The left temple lesion concerned the patient because over the previous 4 months, it had bled intermittently. He denied a history of radiation or trauma to the area. The patient admitted to a 1-year history of anorexia, increasing fatigue, and exertional dyspnea but denied any bony abnormalities or pain. His medical history was significant for bilateral carotid stenosis, diabetes mellitus, psoriasis, chronic renal failure, and eczema.
Pena I, Bell DM, Lewis CM. Pathology Quiz Case 1. JAMA Otolaryngol Head Neck Surg. 2013;139(3):315. doi:10.1001/jamaoto.2013.6
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