Basal cell carcinoma with glandular differentiation

 Case 1461   29.1.16 (R. Carr)  ulcer mid-helix 

Pattern looked metastatic and glandular, suggesting adenocarcinoma or primary hidradenocarcinoma.  However, EMA –ve, ruling out these diagnoses.  BerEP4 +ve.  Also some intravascular spread, highly unusual for BCC and raising the possibility of metastasis.