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 1142 - 7th November 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. Ear. ?BCC

Case Posted by Dr Richard Carr


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Dr. Mona Abdel-Halim

Posted

Looks very interesting and I am sure it will turn out to be something very unusual as we are used to with Dr Carr cases !!!
My theories are:
BCC with extensive apocrine differentiation.
Apocrine carcinoma (ceruminous gland carcinoma) of the ear.
Waiting for the immunos !!!!
Looking forward to read others' suggestions.
I do not think I should think of a metastatic lesion here because the third image shows a point of connection of the tumor with the epidermis rather than the appearence of a metastatic lesion with epidermotropism.

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Mark A. Hurt MD

Posted

I would consider cribriform apocrine carcinoma. I wonder if there might be neuroendocrine differentiation.

I'm writing from the ASDP meeting in Chicago. Catherine Stefanato is speaking on alopecia as I write this.

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Guest Jim Davie MD

Posted

Agree with apocrine carcinoma, with pagetoid spread into epidermis/adnexa.

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Dr. Richard Carr

Posted

This was from external ear. I reported this as an apocrine carcinoma (highly cystic, focally cribriform but quite high grade, with almost bowenoid-like superficial basaloid areas). I guess this is not our normal picture of an apocrine carcinoma (i.e. a pink predominantly tublar tumour) but I don't see what else to call it. I did a few immunos and duct lining cells were positive for Cam5.2, CK7 (patchy), BerEP4 (patchy in gland lining cells therefore not BCC), EMA (more diffusely in basaloid/bowenoid areas, again excluding BCC). CK5 fairly diffuse and p63 diffuse but negative in mature duct lining cells. Oestrogen receptor widely positive. I did not do an neuroendocrine markers. IHC was mean't to appear at 4pm - I have asked the team to post them now. Apologies I was attending the UK National Skin EQA on friday.
Hope you enjoyed your weekends.

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Dr. Richard Carr

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1142_RAC6924x10_p63_IHC_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1142_RAC6925x10_CK7_IHC_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1142_RAC6925x10_Cam52_IHC_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1142_RAC6925x10_ER_IHC_4pm.jpg[/img]

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