Case Number : Case 360 Posted By: Guest

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

This is a difficult case and the differential diagnoses given are good. It is an example of hidradenocarcinoma with clear cell change, squamous differentiation and comedo-necrosis. I did not include a picture of ductal differentiation which was present, confirmed with EMA), just to see which way your minds would go.

Submitted on 27/10/2011 16:32

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Richard Carr - Warwick (UK) Wrote:

We would also have to consider a metastasis. The vast majority of tricholemmal carcinomas occur on the sun-exposed & head and neck of the elderly. Obviously hidradenomocarcinoma could show squamous differentiation so is not ruled out but neither have we seen convincing lumina. Rarely one sees malignant transformation in epidermal & pilar cysts. Regards to all.

Submitted on 27/10/2011 06:00

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Sadiq Mohammed Ali Amer - Al Thawra hospital, Sana'a (Yemen, Sana'a) Wrote:

I am in favour of hidradenocarcinoma with central necrosis resulting in a comedocarcinoma-like appearance

Submitted on 27/10/2011 02:09

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Rodrigo Restrepo - UPB/CES (Colombia) Wrote:

Trichillemmal carcinoma.

Submitted on 26/10/2011 12:37

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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Trichillemmal carcinoma.

Submitted on 26/10/2011 11:52

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Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Agree with Hidradenocarcinoma!!...Thank you very much Philipp and all the people. I learn a lot here every day

Submitted on 26/10/2011 09:36

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Bostjan Luzar - Institute of Pathology, Medical Faculty University of Ljubljana (Ljubljana, Slovenia) Wrote:

Trichilemmal carcinoma

Submitted on 26/10/2011 09:36

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Hazem Hamed - Department of Histopathology, Imperial College (London) Wrote:

Trichilemmal carcinoma.

Submitted on 26/10/2011 08:51

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Pablo Ortega-Espinosa - "Isidro Ayora" Hospital (Loja-Ecuador) Wrote:

I agree with Mona, hidradenocarcinoma, have a nice day!

Submitted on 26/10/2011 08:35

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Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:

Trichilemmal carcinoma. The stroma is too fibroblastic, in some areas there seem to be palisaded clear cells. the nuclei are vesicular with abundant cytoplasm. Squamoid areas and comedonecrosis could be seen.

Submitted on 26/10/2011 05:53

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Mona Abdel Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

I am thinking of hidradenocarcinoma, comedocarcinomatous variant. The extensive central necrosis is characteristic I think. We have also clear cell changes and I can percieve cytoplasmic vacuoles that I interpreted them as intracellular lumina. Squamoid cells and squamous differentiation can be seen in hidradeocarcinoma.

Submitted on 26/10/2011 05:32

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I. Abdul-kadir - SJUH (Leeds, UK) Wrote:

Signet-ring cell squamous cell carcinoma.

Submitted on 26/10/2011 05:19