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a Microscopic view of vulvar biopsy demonstrating squamous cell carcinoma (rightward black arrow) and several keratin pearls (black star). Normal vulvar squamous epithelium is indicated by the leftward black arrow. b Microscopic view of RV mass biopsy showing infiltration by squamous cell cancer (leftward black arrow) along with keratin pearls (black star). Normal myocardium is indicated by black upward arrow.
