A woman in her 60s with a Fitzgerald skin type II presented to the clinic with a 4- to 5-month history of a growing lesion on her right cheek. The physical examination demonstrated a 3.5-cm indurated, semifixed, multifocally ulcerating mass surrounded by an erythematous rim overlying the zygoma with a subdermal and subcutaneous extension measuring 4.2 × 4.5 cm. It was nonpigmented except for a small patch along the inferior margin. The right facial and trigeminal nerve branches were intact. There was no lymphadenopathy. Two punch biopsy specimens were obtained and later demonstrated a malignant neoplasm. The patient underwent wide local excision of the mass with a right parotidectomy and a right lymph node dissection of levels 2A, 2B, 3, and 4.
Rawl JW, Caplan MJ, Lentsch EJ. A Growing Lesion on the Cheek. JAMA Otolaryngol Head Neck Surg. 2014;140(4):383–384. doi:10.1001/jamaoto.2013.6770