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So a dragon horn (sort of) grew on a guy’s back…

By Elizabeth Rayne
Game of Thrones

If you ever wanted to morph into a dragon, you might want to rethink that.

A patient recently gave doctors something they likely never expected when he took off his shirt in the exam room. The 50-year-old man was suddenly a walking piece of fantasy fiction when he revealed a growth on his back that looked more like a dragon horn than anything human. Unfortunately, it didn’t happen to be a result of merging human and dragon DNA (since dragons only exist in Game of Thrones and other fictional worlds). The “dragon horn” was actually a malignant cancer growth. Yikes.

How did it even get there? Cutaneous horns are growths of keratin, a protein that is also the same stuff your nails and top layer of skin are made out of. Most don’t grow to such a gargantuan size. They tend to appear on patients who are at least in their 60s and 70s. While the appearance of a cone or horn can make them look dangerous, most cutaneous horns are benign, though some can be cancerous. This one unfortunately was malignant. What was baffling about this case was that the anonymous patient had virtually no risk factors for the scary diagnosis of squamous cell carcinoma (SCC).

“In terms of risk factors, the patient had no significant sun exposure, no previous or family history of skin malignancy and was not immunosuppressed. He did not take any regular medication but he was a smoker,” said Dr. Agata Marta Plonczak and her team, who examined and eventually operated on the patient, in a study recently published in BMJ Case Reports.

The patient’s light skin didn’t help matters, since those with the lightest skin tones are also at greatest risk of growing cutaneous horns that may or may not turn canceorus. The tumor was excised as soon as possible, with a skin graft from the man’s thigh reconstructing the area of his back on which it had been growing for so long.

What is even more surprising is that there should have been no reason for the patient not to seek treatment for this 5-inch behemoth earlier, especially since he lived in a developed country with free health care. You can imagine that putting up with such a thing was far from built-in cosplay and more of a nightmare than an actual dragon.

“This highlights that despite current public skin cancer awareness and rigorous healthcare measures, cases like this can still arise and slip through the net,” Plonczak and colleagues said.

(via BMJ Medical Reports)