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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 1293 - 08 June 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 a 53-year-old man with an excision of a lesion on the left forearm.

Case posted by Dr Mark Hurt


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IgorSC

Posted

Cutaneous adenoid cystic carcinoma.

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Guest Romualdo

Posted

I think there are decapitation secretion, too much atypia and papillary foci. I think this is apocrine carcinoma.

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Mark A. Hurt MD

Posted

[b]-- CRIBRIFORM APOCRINE ADENOCARCINOMA[/b]
[indent=1][b]COMMENT: [/b]This is a low grade adnexal adenocarcinoma of the skin, and the reported patients have done fairly well in 13 of 26 patients follow-up by Rütten et al in 2009; none of the lesions were known to have metastasized or regrow locally. There was a question about this being a ductal adenoma or mixed tumor, and I don't think it qualifies for either. As a rule mixed tumors will have less of a cribriform pattern and usually have different elements such as peculiar stroma or even cartilaginous stroma and adipose tissue. As a rule the ductal adenomas don't make this stereotyped pattern. Cribriform apocrine carcinoma is an uncommonly found lesion, and it appears to be low grade, but I still think it needs to be excised.[/indent]

[center]Reference[/center]

Rütten A, Kutzner H, Mentzel T, Hantschke M, Eckert F, Angulo J, Rodríguez Peralto JL, Requena L. Primary cutaneous cribriform apocrine carcinoma: a clinicopathologic and immunohistochemical study of 26 cases of an under-recognized cutaneous adnexal neoplasm. J Am Acad Dermatol. 2009 Oct;61(4):644-51. doi: 10.1016/j.jaad.2009.03.032. PubMed PMID: 19751882.

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