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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 1770 - 10 March - 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: F70. Scalp. Sebaceous cyst? With credit to Dr Cliona Ryan for sharing this case.

Case Posted by Dr Richard A Carr

Edited by Admin_Dermpath


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Dr. Mona Abdel-Halim

Posted

My first thought is porocarcinoma too.

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vincenzo polizzi

Posted

No too much pleomorphism, but infiltrative, deep penetrating and lymphovascular growth in fig3, so this porocarcinoma looks like a high risk lesion!

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Mariantonieta Tirado

Posted

I agree Porocarcinoma, cuticular epithelium and tons of mitoses and infiltrative pattern

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Agree with Porocarcinoma. There are atypical poroid cells and this kind of necrosis in picture 4 is also a clue.

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Nitin Khirwadkar

Posted

Agree with porocarcinoma. Great case.

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Robledo F. Rocha

Posted

Two points caught my eyes: (1) the coexistence of benign areas comprising normal poroid / cuticular cellular composition with conspicuous ductal differentiation, and malignant areas showing nuclear pleomorphism, increased mitotic activity, and perineural invasion; and (2) the architecture of multiple neoplastic lobules throughout the dermis. So, my hunch is porocarcinoma evolving from a preexisting dermal duct tumor.

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Josie Bisi

Posted

A tumor of pored cells, mitosis, atypia, rudimentary ducts... I thought porocarcinoma too.

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Dr. Richard Carr

Posted

Yes well done all. I called this a poroid hidradenocarcinoma (agree it's the poroid group i.e. a continuum with porocarcinoma) although it was a large rounded dermal/subcutaneous lump with only very focal connection with the surface. I thought based on being mainly pushing / rounded, with mild cellular pleomorphism it was low-grade although in places mitotic activity was moderately high (13/mm2). Nice nerve infiltration within the lesion and focally perineural invasion at the periphery supporting the diagnosis of malignancy.

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Slow Tortoise

Posted

Porocarcinoma based on its looks  and the distinctive pattern of necrosis.

 

Pray tell what the difference is between a poroid hidradenocarcinoma vs the less of a mouthful porocarcinoma (..if there is one?)

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