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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 2108 - 5 July 2018 Posted By: Dr. Hafeez Diwan

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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70 year-old with left facial “cyst”.

Edited by Admin_Dermpath


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Alice Roberts

Posted

Endocrine mucin producing sweat gland carcinoma or, less likely, adenoid cystic carcinoma. I’d do CK7, ER, PR, synaptophysin, chromagranin.

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Anil Patki

Posted

If the lesion is not on the eyelid, adenoid cystic carcinoma (either primary or metastatic from a salivary gland tumour) is more likely. 

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Dr. Richard Carr

Posted

Looks like one of those mucinous carcinomas with more solid areas. Good to do a myoepithelial marker to look for an in situ component. Can have endocrine differentiation as suggested above.

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anh

Posted (edited)

The first figure shows a multinodular tumor . I think you can also see an elongated cystic duct lined by two or three cell layers. I think that ductal structure is benign, most likely eccrine in nature. The first two figures might also show mucin in the stroma (first I thought it was fat, but I think it's more likely mucin after i read other comments). The last picture shows fibrovascular core in the nodule, reminiscent of solid papillary carcinoma of the breast. Everytime I see a cutaneous tumor that looks like a solid papillay carcinoma of the breast , I think of endocrine mucin- producing sweat gland carcinoma.

I think one sees basement-like material in the tumor nests of adenoid cystic carcinoma, not fibrovascular cores. Besides, adenoid cystic carcinoma is composed of basaloid cells.

Edited by anh

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vincenzo

Posted

So-called Endocrine Mucin Producing Sweat Gland Carcinoma, with early stromal infiltration. I favor this diagnosis because of a distorted eccrine ductal structure between cribriform epithelial nodules in fig 1. 

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Dr. Mona Abdel-Halim

Posted

Or polymorphus sweat gland carcinoma

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