F 83, painless lump, left cheek

    An 83-year-old white American woman of European descent
    presented to the Dermatology clinic complaining of a small
    painless “lump” on her left cheek that had been present
    for several months. She did not have a past history of any
    significant medical illness including any neoplastic disease.
    Physical examination revealed a 7mm soft papule with
    overlying intact skin on the left cheek. There was no evidence
    of any sun-induced skin lesion. There were no palpable
    lymph nodes in the neck. Clinical impression was that
    of a benign subcutaneous nodule such as a lipoma. The
    patient was advised of conservative follow-up, but the patient
    insisted on having the lesion removed.
    An excisional biopsy was performed.