Case Number : Case 491 Posted By: Guest

[b]Phillip H McKee - Overseas Consultations (Cave Creek, Arizona, United States) Wrote:[/b]

This is a spindle cell melanoma. Diagnosis obviously depends upon immunohistochemistry. I included the case because of Figure 4 which shows "uncertain vascular invasion" which is thought by some to impart a worse prognosis. I suspect that it implies that there may be true vascular invasion somewhere deeper in the block.

[size=2]Submitted on 26/04/2012 20:54[/size] [b]Eman El-Nabarawy - Cairo University (Egypt) Wrote:[/b]

Thought of malignant fibrous histiocytoma.

[size=2]Submitted on 26/04/2012 20:30[/size] [b]Yüksel Okumuş - Bursa State Hospital (Turkey) Wrote:[/b]

Angiosarcoma

[size=2]Submitted on 26/04/2012 20:18[/size] [b]Sameh Abdelkodous - Al Azhar Faculty of medicine (Cairo Egypt) Wrote:[/b]

I favour angiosarcoma

[size=2]Submitted on 26/04/2012 19:55[/size] [b]Mario Fernando Dueñas A. - Oficina de Patología Doctor Mario Fernando Dueñas A. (Pasto. Nariño. Colombia. South America) Wrote:[/b]

Malignant fibrous histiocytoma with haemangiopericytic pattern

[size=2]Submitted on 26/04/2012 18:40[/size] [b]Marwa Fawzy - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:[/b]

Angiosarcoma,with agreement with others'differentials

[size=2]Submitted on 26/04/2012 17:15[/size] [b]Mona Abdel Halim - () Wrote:[/b]

Agree with differentials mentioned, with leiomyosarcoma followed by spindle cell angiosarcoma on the top.

[size=2]Submitted on 26/04/2012 16:25[/size] [b]omar erdogan - () Wrote:[/b]

metaplastik carcinoma of the skin

[size=2]Submitted on 26/04/2012 15:25[/size] [b]Engin Sezer - (Istanbul) Wrote:[/b]

My differentials include those of cellular fibrous histiocytoma (which I favor based on epidermal induction), spindle cell SCC, leiomyosarcoma and spindle cell AFX. Panel including F XIIIa, MNF-116, desmin and CD99 may be helpful.

[size=2]Submitted on 26/04/2012 13:50[/size] [b]A Bansal - BCU HB (North Wales) Wrote:[/b]

Based on morphology, favour angiosarcoma. Differential Dxs: spindle cell SCC, spindle cell melanoma, AFX. Requires IHC.

[size=2]Submitted on 26/04/2012 13:48[/size] [b]Izzat Abdul-kadir - ST2 - York Hospital (UK) Wrote:[/b]

I agree with the below. There seem to vascular spaces, so I would start with angiosarcoma. I would leave synovial sarcoma last, as I understand it's rare that it's superficial.

[size=2]Submitted on 26/04/2012 13:32[/size] [b]Hazem Hamed - Department of Histopathology, Imperial College (LONDON) Wrote:[/b]

Malignant spindle cell tumour for immunohistochemistry. DD includes: Sarcomatoid squamous cell carcinoma, Spindle cell melanoma, Leimyosarcoma, monophasic synovial sarcoma,angiosarcoma and sindle cell varient of AFX/pleomorphic dermal sarcoma.

[size=2]Submitted on 26/04/2012 13:02[/size]