Pearly Facial Nodule as a Presentation of Late Metastasis of Retroperitoneal Leiomyosarcoma

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A 67-year-old Caucasian man presented to the authors' general dermatology clinic for evaluation of a gradually enlarging, tender nodule on the lower lip that had developed over the past 9 months. The patient denied a personal or family history of skin cancer. An extensive review of systems was negative for other symptoms. On physical examination, there was a 10 × 11 mm multilobulated, pearly, round nodule with telangiectasia visible both grossly and on dermoscopy on the lower cutaneous lip abutting the vermilion border. Given high clinical suspicion for basal cell carcinoma, the patient was referred directly to our unit for Mohs micrographic surgery (MMS) without an initial biopsy.

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