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History: The patient is a 75 yo black male woh presented to the Washington University outpatient clinic because of an asymptomatic growth on his right chest. The growth had been slowly increasing in size over the past two years.
Physical Examination: On the right breast involving the areola,was a 9 cm in size, exophytic, tumor nodule with a verrucous surface (Fig. A). The tumor extemded subcutaneously for approximately 12 cm. Diffuse lymphadenopathy was present in the right axilla.
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