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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 2001 - 06 Feb 2018 Posted By: Iskander H. Chaudhry

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75 Male, Right neck excision. ?BCC.

Edited by Admin_Dermpath


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A tumour of poroid cells showing exophytic growth pattern, ductal structures, necrosis and mitoses.At places seen to be infiltrating the dermis. A poroma turning malignant ?

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Raul Perret

Posted

Yes porocarcinoma came to my mind too, CEA could highlight the ducts

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vincenzo polizzi

Posted

I don't see any ductal differentiation. Why not a sebaceous carcinoma, LOW GRADE?

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Uma Sundram

Posted

These cells look really big and vesicular. I'm going to be a wimp and say 'adnexal tumor, NOS'. I like porocarcinoma, though. Another thought is a really poorly differentiated SCC with ?viropathic changes? I see some pigment too but really think it's epithelial.

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vincenzo polizzi

Posted

BerEp4 is often positive in Sebaceous Carcinoma. 

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Dr. Richard Carr

Posted

IHC would be okay for BCC. I'd probably go for either an odd BCC or trichoblastoma. Morphologically sebaceoma was a consideration but BerEP4 is almost always negative. An entirely circumscript sebaceous carcinoma (in situ) may be a possibility. I see some mitotic activity but not much in the way of cellular pleomorphism. I'd like to add adipophilin, CD10, CK20, Ki67, p53. I was least in favour or a poroid/ductal tumour. Funny as I have quite a similar case on my desk right now!  I don't think there is any metastatic potential with the circumscription we see here it's ultimately a little academic but rather a fun puzzle!

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Arti Bakshi

Posted

A sebaceous tumour is my prime suspicion! The cells are germinative rather than poroid so not in favour of porocarcinoma. An adipophilin is a must as sebaceous differentiation may be very focal/subtle. If its is sebaceous, would best fit with an insitu sebaceous carcinoma. 

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Admin_Dermpath

Posted

Dr Chaudhry:

Classed as adnexal carcinoma favouring sebaecous - the lesion is not entirely in situ. Adipophilin requested and update to follow!

 

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Is there some pigment?

Any melanocytes for melanocytic matricoma? 

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