Case Number : Case 433 Posted By: Guest

[b]Zena Slim - Wessex Deanery () Wrote:[/b]

Common things are common as the saying goes ! ..history is all important too

[size=2]Submitted on 09/02/2012 06:23[/size] [b]Yüksel Okumuş - Bursa Devlet Hastanesi (Turkey) Wrote:[/b]

Surprise !

[size=2]Submitted on 06/02/2012 19:09[/size] [b]Phillip H McKee - Overseas Consultations (Cave Creek, Arizona, United States) Wrote:[/b]

This is an extremely difficult case and most of your suggestions are excellent although wrong. Obviously immunohistochemistry is essential and the tumor cells were strongly keratin positive. Everything else was negative (S100-protein etc) I believe this case comes from Wayne Grayson and that this lesion is a recurrence from a poorly differentiated but diagnosable squamous cell carcinoma. It goes to show that even SCC can be as spindled and undifferentiated as in this example. Without prior knowledge, I wouldn't have though of it either. Shame on me!!!!!!

[size=2]Submitted on 06/02/2012 18:42[/size] [b]omar erdogan - () Wrote:[/b]

fasciitis

[size=2]Submitted on 06/02/2012 18:36[/size] [b]Eman El-Nabarawy - Cairo University (Egypt) Wrote:[/b]

Angiosarcoma.

[size=2]Submitted on 06/02/2012 17:01[/size] [b]jmg pat - pu (Colombia) Wrote:[/b]

angiosarcoma

[size=2]Submitted on 06/02/2012 16:08[/size] [b]Zena Slim (SpR Histopath) - Wessex Deanery (QAH Portsmouth) Wrote:[/b]

A infiltrating spindle cell tumour which needs an immuno-panel. I would include DFSP,Desmoplastic Melanoma,spindle cell carcinoma, MPNST, and Atypical FibroXanthoma in my differentials. I would want to exclude leiomyosarcoma and angiosarcoma but I don't think they are in this case.

[size=2]Submitted on 06/02/2012 16:02[/size] [b]Mona Abdel Halim - Dermatology Dept. Cairo Univ. (Egypt) Wrote:[/b]

Favoring angiosarcoma,

[size=2]Submitted on 06/02/2012 13:40[/size] [b]Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:[/b]

Angiosarcoma

[size=2]Submitted on 06/02/2012 13:36[/size] [b]ANDREW DANCKWERTS - WITS UNIVERSITY (JOHANNESBURG, RSA) Wrote:[/b]

MALIGNANT SPINDLE CELL NEOPLASM. THE DIFFERENTIAL DIAGNOSIS INCLUDES THE FOLLOWING: (1) LEIYOMYOSARCOMA (2) ANGIOSARCOMA (3) MPNST (4) AMELANOTIC MELANOMA (5) SPINDLE CELL CARCINOMA & (6) AFX - DIAGNOSIS OF EXCLUSION. ********************************************* AN EXTENSIVE IMMUNOHISTOCHEMICAL STAINING PROFILE IS REQUIRED TO DIFFERENTIATE BETWEEN THE ABOVE ENTITIES.

[size=2]Submitted on 06/02/2012 12:15[/size] [b]Richard Carr - Warwick (UK) Wrote:[/b]

Agree spindle cell / desmoplastic melanoma is most likely (needs immuno)

[size=2]Submitted on 06/02/2012 11:09[/size] [b]A Bansal - BCU HB (North Wales) Wrote:[/b]

Angiosarcoma was my other differential and you may well be right.

[size=2]Submitted on 06/02/2012 11:05[/size] [b]Yüksel Okumuş - Bursa State Hospital (Turkey) Wrote:[/b]

Anjiosarcoma

[size=2]Submitted on 06/02/2012 10:57[/size] [b]A Bansal - BCU HB (North Wales) Wrote:[/b]

Desmoplastic melanoma. Would corroborate with immunohistochemistry.

[size=2]Submitted on 06/02/2012 10:53[/size]