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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 921 - 2nd January Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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52 year-old female with labial biopsy. No history provided.

Case posted by Dr. Hafeez Diwan.


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Eman El-Nabarawy

Posted

Adenoid cystic carcinoma. Favor metastatic over the primary type as the primary form typically occupies the mid and lower dermis while in this case the tumor islands involve the papillary dermis (with epidermotropism, I guess!!).

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Guest Romualdo

Posted

Salivary duct carcinoma or a metastatic adenocarcinoma, possibly colonic.

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I think it is a metastatic adenocarcinoma to skin. Need Immunohistochemistry.

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Secondary Paget disease and cutaneous metastasis, from either a uterine (including endocervical) or colorectal adenocarcinoma.

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Dr. Mona Abdel-Halim

Posted

I will call this metastatic epidermotropic adenocarcinoma, the primary could be salivary or others...

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Guest Ali Y. Hashim

Posted

Paget disease, secondary type, of anorectal adenocarcinoma.

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Dr. Mona Abdel-Halim

Posted

I think we need to know the exact site!!!! Labial: referring to the lips or labial: referring to labia majora or minora (genital)??? In case of a genital location, one should consider also invasive EMPD in addition to metastatic epidermotropic adenocarcinoma ....

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Mark A. Hurt MD

Posted

I suspect rectal or colonic carcinoma metastatic to the skin.

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Robledo F. Rocha

Posted

Epidermotropic metastatic adenocarcinoma. Once intracytoplasmic mucus vacuoles can be seen in the Picture #3, I favor endocervical adenocarcinoma, ovarian mucinous adenocarcinoma, and colorectal adenocarcinoma.

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Guest Jim Davie MD

Posted

Probability would favor metastatic adenocarcinoma over a primary adenocarcinoma of vulva. I would favor an endometrial or cervical primary, if metastatic.

More rare, but in the differential: primary sweat duct adenocarcinoma of labia (if labia majora) or Bartholin's duct adenocarcinoma (if labia minora).

Need clinical correlation and/or stains to help differentiate.

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Guest Romualdo

Posted

Yes, labial biopsy refers to a vulvar lesion or an oral one?

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Guest Maria George

Posted

I favor metastases from granulosa cell tumor of the ovary.

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Guest Ahmed F Lazim

Posted

Primary bartholin gland adenocarcinoma, or metastatic endometerial adenocarcinoma with cribriform plates

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Dr. Hafeez Diwan

Posted

I apologize for not commenting yesterday. This is a lady with a vulvar lesion, which was extramammary Paget's disease. There was no internal malignancy in her case.

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Guest DIANA GUTIERREZ

Posted

Salivary duct carcinoma or a metastatic adenocarcinoma

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