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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1512 - 11 April 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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The patient is a 97 year old white man with a shave biopsy of a bleeding cutaneous horn taken from the right pretibial area. Clinical Diagnosis: r/o SCC.

Dr Mark Hurt.
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  Report Record
Go to records April 2016

User Feedback


Raul Perret

Raul Perret 262

Posted

The morphology makes me consider mainly a poorly differentiated form of squamous cell carcinoma (infiltrative or with single cell infiltration) I would perform other immunos like p63/p40, ck5/6, cam 5.2 etc. they could help to support the diagnosis and also it would be interesting to see if this extremely cellular stroma has any positive cells as it could represent sarcomatoid differentiation/dedifferentiation.

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Guest Arash Daryakarr

Guest Arash Daryakarr

Posted

I wish to raise the possibility of metaplastic carcinoma of skin.

Although spindle cell SCC and high grade sarcomas remain as differentials.

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Guest

Carcinosarcoma, with the epithelial component being an infiltrative BCC. 

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Nitin Khirwadkar

Nitin Khirwadkar 63

Posted

Agree. More IHC for the spindled component.

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

Metaplastic carcinoma / carcinosarcoma.  BCC more likely than SCC statistically and with the pattern but BerEP4/EMA should help. Intermixed sarcomatoid & epithelial cords argue against collision of BCC/SCC with cutaneous sarcoma (AFX-type).

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SADAT
Carcinosarcoma
Agree for more immuno as described by Raul in addition to BeErep4/EMA as Requested by Carr

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vincenzo polizzi

vincenzo polizzi 185

Posted

Yes. Agree with Metaplastic Carcinoma, probably metaplastic BCC.

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