In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 905 - 6th December 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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M80. Non healing lesion, 10mm, 2/12, lower leg. ?acroangiodermatitis of Mali.

Case posted by Dr. Richard Carr.


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Hanan Vaknine MD

Posted

Marjolin's ulcer associated with squamous cell carcinoma arising in the background of stasis change (dermatitis) would be my working diagnosis, however one may also consider pseudoepitheliomatous hyperplasia as an alterative diagnosis, which is also acceptable in this case. The fibrinoid necrosis may also be indicative of an additional component of atrophie blanche.

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Robledo F. Rocha

Posted

Squamous cell carcinoma arising in the setting of long-term vascular insufficiency.

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Dr. Richard Carr

Posted

No one got it yet. I suggest you look at the low power again. I have asked Iskander's team to post IHC at 4pm.

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Dr. Mona Abdel-Halim

Posted

If no one got it yet, then I will consider the DD that I was thinking of earlier but was not confident about it: syringo squamous metaplasia??

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Dr. Richard Carr

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE905_RAC6568x10_EMA_LR.jpg[/img]



[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE905_RAC6568x10_BerEP4_MR.jpg[/img]

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Dr. Mona Abdel-Halim

Posted

Ok, after the Immunos were placed, I revised again the low power, second section shows some basaloid islands-did not recognize them earlier-, now thinking of collision tumor (SCC and BCC?) or syringo squamous metaplasia with BCC?

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Hanan Vaknine MD

Posted

Collision tumor (SCC and BCC); with the kind help of Mona; The squamous proliferation appears rather prominent for metaplasia in my opinion

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Eman El-Nabarawy

Posted

SCC and BCC developing at the edge of stasis dermatitis ulcer.

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Dr. Richard Carr

Posted

I reported this as superficial BCC with pseudoepitheliomatous hyperplasia in the setting of chronic venous stasis. PEH associated with BCC can be very striking and easily mis-diagnosed as squamous cell carcinoma. The venous stasis changes add to the confusion!
Enjoy your weekends.

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Robledo F. Rocha

Posted

I've first interpreted the basaloid islands that appear on low power view as an area of less differentiated squamous cell carcinoma. After immunostaining it's hard to hold that same opinion.
Nice case, Dr. Carr. Thanks for sharing it.

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