Jump to content
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 2007 - 14 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.
Submitted Date :
   (0 reviews)

55 year Male: Left thigh excision biopsy.
?DF ? Sarcoma

Edited by Admin_Dermpath


  • Like 1
  Report Record

User Feedback


basal cell carcinoma - peripheral palisading, retraction artifacts.

Share this comment


Link to comment
share_externally

Don't really see ducts but the silhouette of the tumor makes me think of a poroma.

Share this comment


Link to comment
share_externally

I thought about poroma too but for above reasons I favor basal cell carcinoma.

Share this comment


Link to comment
share_externally

Benign basaloid proliferations arising from a follicle. Pilar sheath acanthoma. Dirk Elston calls it a dilated pore of Winer on steroids!

Share this comment


Link to comment
share_externally

Dr. Mona Abdel-Halim

Posted

Favoring pilar sheath acanthoma (unusual clinical site and unusual large size). Poroma will not have peripheral palisades.

Share this comment


Link to comment
share_externally

Dr. Richard Carr

Posted

I think it's a poroma group lesion i.e. poroma/hidradenoma. I'd like to see the typical amorphous collagen of these lesions. Occasionally you can look hard and find no lumina. I still favour "pauci-luminal" hidradenoma in those cases that look like this tumour. We can do a little IHC to put nodular BCC to bed (BCC are very characteristically BerEP4 diffuse and strong, EMA completely negative in the basaloid epithelium in >95% of cases). The lesion is mitotic so I sometimes run p53 but hidradenomas can be quite mitotic. I normally recommend complete excision of mitotically active but otherwise benign / indolent adnexal tumours (pilomatrixoma excepted). I might say any mitotically active lesion occasionaly undergoes malignant transformation. I have found some BCC that I have mis-diagnosed as hidradenoma and vice versa. For some reason BCC with pale/clear cells patterns can have markedly reduced BerEP4 and duct like spaces and squamous morular changes very easily confused with hidradenoma. Importantly the BerEP4 should highlight the peripheral palisade in such cases but not in hidradenoma. One should also be cognizant that lesions such as this, that have been sliced across, might give rise to the rare phenomenon of "benign" metastasis (local lymph node involvement) presumably as lesions cells were pushed in to lymphatic during the original procedure.

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...