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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 605 - 3 Oct Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Male 82 years with a 2.0 cm tumor on his scalp.
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Go to records October 2012

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Guest Guillermo Solis

Guest Guillermo Solis

Posted

Blue and round cell tumor, Merkel cell carcinoma, metastatic tumor (small cell lung cancer, visceral undifferentiated carcinoma)

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Sasi Attili

Sasi Attili 85

Posted

Surprised by the relatively low mitotic activity, but has to be malignant! Looking at it again, agree MCC is likely. Think need immunos to evaluate including S100, CK, EMA, LCA, SMA, vimentin, desmin, CD 34, CK 20, CK7, NSE etc. Need to r/o metastasis.

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Guest Dr. Shashi Baksh

Guest Dr. Shashi Baksh

Posted

Differentials: Neuroendocrine carcinoma, primary cutaneous versus metastatic. Also want to rule out a primary adnexal carcinoma versus metastatic carcinoma. Will do a battery of immunos CK7, 20, chromogranin, synaptophysin, S100, pankeratin, EMA, CEA, LCA.
At this point poorly differentiated carcinoma with perineural invasion, immunos to further categorize. Also on the scalp of an elderly gentleman, don't see any suggestion of vessel formation but I will do a CD31and CD34 to rule out an epithelioid angiosarcoma.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

MCC vs metastatic small cell lung carcinoma..

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Hanan Vaknine MD

Hanan Vaknine MD 18

Posted

The nuclear clearing, as seen in this case, is highly suggestive of [color=#FF0000][b]MCC [/b][/color](my diagnosis)

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Guest MarieMD

Guest MarieMD

Posted

Merkel cell ca, rule out metastatic neuroendocrine ca.

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Guest
MCC - nuclear clearing & fragments - for CK20 to rule out (or confirm) metastatic small cell lung carcinoma

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Guest
Agree with the consensus, MCC.

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Dr. Phillip McKee

Dr. Phillip McKee 130

Posted

Well done. Merkel cell tumor is correct.

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