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History

A 52-year-old man presents with a 9 month history of a tumour on his left ear. This does not bleed and has not enlarged significantly over this period, however, it is tender when touched and wakes him at night if he lies on his left side. He works outdoors and has had solar keratoses treated with cryotherapy in the past, however he has had no previous treatment on the ear and is otherwise in good health.