You might think a horn-like growth on the face would be call for urgent action, but an elderly man in China waited 10 years before presenting to doctors with his unusual lesion.

The solid 8cm growth from his cheek was described as a “grey-brown, firm, keratotic cutaneous horn”.

The 91-year-old man had no pain, pruritis or other symptoms and said the slow-growing lesion had developed over a decade.

After surgical excision of the entire horn, histopathology revealed atypical keratinocytes and ‘horn pearls’ within the dermis, with hyperchromatic and pleomorphic nuclei.