Case Number : Case 240 Posted By: Guest

Phillip McKee - Overseas consultations (Cave Creek, Arizona, USA) Wrote:

Again I have to go out for most of the day and so am posting the answer early. The tumor does show very focal sebocytes with crenated nuclei although I do agree that the majority show clear cell change. The nuclei are pleomorphic and hyperchromatic. The lesion is a poorly differentiated sebaceous carcinoma in which sebaceous differentiation is often focal and difficult to find. I like the differential diagnoses of clear cell SCC, clear cell porocarcinoma or hidradenocarcinoma. Clear cell melanoma is also an important consideration.

Submitted on 11/05/2011 12:33
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Mona Abdel Halim - Dermatology Department, Faculty of medicine, Cairo University (Egypt) Wrote:

In this section I would rather think of tumors with clear cell changes rather than sebacous neoplasm. Some of the cells have ecenteric nuclei (signet ring cell like), the cytoplasm looks clear to finely reticulated, not foamy and bubbly like that of sebocytes. Moreover, in the right lower part of the field, I can percieve esinophilic cytoplasm around the nuclei which is then surrounded by clear spaces.. I thought of clear cell SCC (the non keratinizing variant which does not show foci of keratinization or the pleomorphic type wich may show microcysts containing acantholytic cells).The other possibility is a hidraadenocarcinoma or a porocarcinoma with clear cell change (may be else where there is evidence of ductal differentiation). Clear cell renal carcinoma is not the case as well as balloon cell melanoma.

Submitted on 11/05/2011 04:44
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Sebaceoma.

Submitted on 11/05/2011 00:23
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Rebecca Shanesmith - OU Medical Center (OKC, OK, USA) Wrote:

Sebaceoma

Submitted on 10/05/2011 20:47
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