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That's US $178m today for those who are curious

Say one is still sitting on 3650 coins from 2011, and you decide now is the time to sell the lot. How exactly do you "cash out" that amount?

Sell to Elon maybe? ;)

You can sell OTC. Pretty sure all the major exchanges have OTC desks now.

You can definitely try to barter it.

The top reputable exchanges have daily liquidity in the billions https://coinmarketcap.com/rankings/exchanges/.