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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 1348 - 24 August 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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The patient is an 88 year white man with a shave curetting of a 7mm papule on the left cheek.

Case posted by Dr Mark Hurt


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Dr. Mona Abdel-Halim

Posted

Thought of carcinosarcoma

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Mark A. Hurt MD

Posted

[b]-- BASAL CELL CARCINOSARCOMA[/b]
[b]COMMENT: [/b]The pattern seen in this specimen is mostly like basal cell carcinoma containing a sarcomatous pattern similar to an "atypical" fibroxanthoma. Cases from the literature are relatively sparse, and most of the patients have done relatively well with adequate excision, with just a few exceptions. Many of the patients lesions, in the stromal components, had unusual sarcomatous patterns including osteosarcoma, most commonly, and less likely leiomyosarcoma and chondrosarcoma. The current case is even more unusual in that the stromal components have an "atypical" fibroxanthoma pattern of sarcoma.

Harvey NT, Sinha A, Houghton DC, Beer TW, Kingston FJ, Yu L, Wood BA. Basal cell carcinosarcoma: a report of 4 cases and review of the literature. Am J Dermatopathol. 2014 Jun;36(6):483-9. doi: 10.1097/DAD.0000000000000017. Review. PubMed PMID: 24698934.

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