Radical mastectomy specimen showing ulceration and retraction of the nipple and peau d' orange appearance of the surrounding skin. Peau d' orange (skin of an orange; orange peel appearance) is due to dermal edema caused by obstruction of the superficial cutaneous lymphatics by the tumor. The infiltrated skin is tethered by the sweat ducts such that it cannot swell, leading to a dimpled appearance. Case contributed by: Dr. Sanjay D. Deshmukh, Dept. of Pathology, S. K. Navale Medical College, Pune, India.