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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 1612 - 30 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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65 year old woman with left post auricular cyst. F6=ck7; F7=EMA; F8=p63.

Case Posted by Dr Uma Sundram


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vincenzo polizzi

Posted

Agree with a primary tumor of the skin, thinking of Low grade mucoepidermoid carcinoma of the skin.

Primary cutaneous mucoepidermoid carcinoma Chun W. Ng1, Richie C. Chan2, Ronnie S. Ho3, Jimmy Y. Chan

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Raul Perret

Posted

My impression is as you guys mentioned that this is not a metastatic tumor but a primary one. Based on topography I cannot rule out cutaneous extension of a primary salivary gland neoplasm or more rarely a primary ceruminous gland neoplasm with compromise of the masthoideal region. Clinical information is extremely important in a case like this (compromise of the parotid gland? Hearing loss? External ear canal compromise?). Carcinoma ex pleomorphic adenoma could make an image like this one, also thought of high grade MEC, I would consider making more immunos like PLAG1 in this case and eventually molecular before making a diagnosis of primary sweat gland carcinoma

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Nitin Khirwadkar

Posted

Agree with the suggestions above.

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Uma Sundram

Posted

Primary cutaneous apocrine carcinoma. Imaging studies showed that the tumor is relatively superficial, making direct extension from other structures such as the parotid gland unlikely. No involvement of ear canal or hearing loss. For low grade mucoepidermoid carcinoma, should see so called mucous cells, which are lacking in this case. Areas of typical PA were not present, and PLAG1 and HMGA2 were both negative. Great suggestions everyone! A difficult case.

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