What Is Your Diagnosis? Extraocular Sebaceous Carcinoma

A 51-year-old man was referred to the dermatology department for a symptomless tumor below the right nipple that had a tendency to bleed. The patient reported that the lesion had started as a small papule that slowly enlarged over 4 months. He had no history of cutaneous trauma, excessive sun exposure, immunodeficiency, or radiation treatment in early childhood. Physical examination revealed a firm, ulcerated, yellow to red, dome-shaped, nodular mass overlying the chest below the right nipple, measuring 2.5 cm in diameter. A cutaneous biopsy specimen was obtained from the tumor and sent for histologic analysis.