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

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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75 Male, Right neck excision. ?BCC.


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Anil Patki

Posted

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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Anil Patki

Posted

BCC sine palisading and retraction artifact

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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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dpath

Posted

Is there some pigment?

Any melanocytes for melanocytic matricoma? 

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