Jump to content
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 1840 - 16 June - Dr Richard A Carr Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

Clinical History: F50. 6/12 growing lesion below right nostril. c/o Dr S. Mahalingham and Dr Abbie Pugh.

Case Posted by Dr Richard A Carr

Edited by Admin_Dermpath


  • Like 2
  Report Record

User Feedback


Admin_Dermpath

Posted

Wrap up your week with a bumper spot diagnosis case from Dr Richard A Carr.

Geoff Cross - DermpathPRO Projects

Share this comment


Link to comment
share_externally

Raul Perret

Posted

Seems like another primary cutaneous mucinous carcinoma (after cpc). How many have we seen this year? Like 3 or something like that? This is great. I think we can morphologically see the natural history of the disease, from the in situ ductal lesions to the inasive neoplasm.

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

I’m thinking of a malignant ( low grade ) mixed tumor of the skin/malignant chondroid syringoma. 

Share this comment


Link to comment
share_externally

Dr. Mona Abdel-Halim

Posted

Primary cut mucinous carc is my first thought

Share this comment


Link to comment
share_externally

nick turnbull

Posted

primary cutaneous mucinous carcinoma.

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

S100+ myoepithelial cells are more in keeping with mixed tumor. Anyway I think morphology supports MT diagnosis, also, if I’m not fully off the track...

Share this comment


Link to comment
share_externally

Raul Perret

Posted

Is not infrequent for PCMC to show prominent myoepithelial cells, and s-100 is a capricious staining (in the literature I have seen conflictive results regarding this marker). I do agree that mixed tumor could come to the differential but I dont see chondroid and stromal components that we usually see in eccrine mixed tumor

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

Found this interesting article

 Malignant chondroid syringoma: Report of a case with lymph node metastasis 12 years after local excision
Akira Watarai MD, Yasuyuki Amoh MD, Ryoichi Aki MD, Hiroshi Takasu MD, Kensei Katsuoka
Dermatology Online Journal 17 (9): 5 

Kitasato University School Of Medicine, Sagamihara, Kanagawa, Japan

 

Share this comment


Link to comment
share_externally

Pablo Gonzalvo

Posted

primary cutaneous ductal myoepithelial carcinoma

Share this comment


Link to comment
share_externally

Dr. Richard Carr

Posted

A very challenging case it appears! I reported this as a benign mixed tumour of skin (chondroid syringoma). I was a bit concerned by the degree of mitotic activity in the myoepithelial component but re-assured by the nice circumscription and lack of cellular pleomorphism. I indicated that if the lesion were to recur locally it should be excised completely. To my eye this is "stromal" type mucin in the setting of mixed tumour rather than epithelial type mucin seen in mucinous carcinoma. Also the range of cells from well formed central ducts in places, intermediate or slightly squamoid cells and rather striking myoepithelial differentiation are not typical for a mucinous carcinoma. We know even benign looking mixed tumours and hidradenomas can show so-called benign metastasis and I think Kazakov has also reported on a number of otherwise benign mixed tumours with an intra-lymphatic component. Sadly we no longer appear to stock hyaluronidase in order to confirm the nature of the mucin in this case but I was satisfied with the diagnosis based on the features above.

Share this comment


Link to comment
share_externally

Abbie Pugh

Posted

Thank you Richard and everyone else for your opinions. Interesting case, we will follow it up.

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...