Case 122 Medical History A 59-year-old white skinned patient attended an ENT outpatient clinic complaining of right unilateral nasal obstruction for the past 8 months, recurrent mild nosebleeds and loss of 7 kilos (246.9 ounces or 15.4 pounds) in the past 60 days. The patient denied any other nasal discharge. He had well-controlled hypertension and denied smoking, alcohol intake or any other comorbidity. During rhinoscopy, a lesion was found and photographed. There were no enlarged lymph nodes and no alterations were observed on mouth or ear examination. Image 1: Photograph taken during right rhinoscopy. Question:Based on the clinical history and image provided, which is the most likely diagnosis? Nasal polyposis Mucosal leishmaniasis Melanoma Squamous cell carcinoma Time is Up! Time's up