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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 1850 - 30 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.
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Clinical History: F85. Rapidly growing exophytic lesion excised from 2nd toe.

Case Posted by Dr Richard A Carr


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Admin_Dermpath

Posted

Dr Richard A Carr wraps up June with a bumper set of images, enjoy.

Geoff Cross - DermpathPRO Projects

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urmilapandey

Posted (edited)

thinking on the lines of mucinous carcinoma (to exclude metastasis), wondered if there is some chondroid material in image 7 and rather plasmacytoid cells in image 11- ?malignant chondroid syringoma...epithelial and myoepthelial markers...

Edited by urmilapandey
typo error

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Raul Perret

Posted

In a tumor with this morphology, infiltrative, with ductal, myoepithelial and squamoid differentiation as well as hyaline, osteoid like areas I would agree with malignant mixed tumor

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vincenzo polizzi

Posted

I was thinking of a metastatic (?breast) cancer, with the "metaplastic carcinoma" features. There is a neoplastic intravascular trombosis in fig 3. But Raul's and Urmilapandey's spot is a good diff.

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Dr. Mona Abdel-Halim

Posted

I thought of malignant mixed tumor

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Dr. Richard Carr

Posted

I called this benign mixed tumour (chondroid syringoma). The necrosis was limited to the superficial aspect (most likely due to pressure necrosis or local trauma). The lesion lacked mitotic activity or cellular pleomorphism and peripheral borders were relatively circumscribed (not well shown in these images). I think the clinical history can be misleading, particularly in the elderly. There are tubular areas with pseudoinfiltrative pattern within the main bulk of the lesion. We've discussed previously how hidradenomas on the ventral surfaces of the feet can show rather infiltrative like patterns and I interpreted this as a similar phenomenon in this otherwise benign appearing lesion.

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