In 2006, an 83-year-old Caucasian male presented himself to the outpatient clinic with cosmetic complaints of an increasingly purple-coloured right earlobe, which had developed over the last few months. His medical history consisted of hearing loss on both sides since 1993, without a clear ENT focus. Intoxication showed no smoking and moderate alcohol consumption (2 units/day). The patient was not on regular medication and had no allergies. The swelling was not painful and he had no weight loss, fever or night sweats. He otherwise felt well and had no other complaints. Upon physical examination it was found that the swelling was purple-red, non-tender and that it felt rubbery. There were no palpable lymph nodes and no hepatosplenomegaly. The neurological exam was unremarkable. A biopsy was performed in the surgery department.