A 66-year-old, otherwise healthy man presented to our clinic with a large tumor on the left shoulder. The patient reported that the lesion had initially been a small, firm nodule that appeared six years before, that enlarged slowly during the following years and more rapidly in the past nine months. At first, the patient did not seek medical attention because of hesitation. On physical examination, a smelling, ulcerated, exophytic tumor, with a cauliflower-like appearance, measuring 20×15×6cm, was observed on the left shoulder (Fig.