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A 71-year-old man schedules an appointment with dermatology clinic after being lost to follow-up for 3 years. During his last visit, he was diagnosed with basal cell carcinoma on the helix of the right ear. At the time, he did not proceed with surgical excision as he wished to seek a second opinion from a naturopathic healer. Based on the typical progression of untreated basal cell carcinoma, what is most likely to seen during his appointment today?