Two years ago I reported a case of poikiloderma atrophicans vasculare.1The patient was a man, 30 years old, whose body was largely covered with typical lesions of poikiloderma in various stages of development. The earliest lesions had started twelve years earlier. Illustrations of the various lesions and details of the history, which was carried to February, 1921, were given in that report and need not be repeated here. The patient was not seen again until April 4, 1922, when he consulted me about a tumor of the right shoulder which had begun to appear four weeks before, and which was growing rapidly and was accompanied by some pain. Over the front of the right shoulder, extending on to the chest below the clavicle and on to the upper part of the arm, there was a round, hard tumor about 10 cm. in diameter. It was about 3 cm.