Case Number : Case 2114 - 13 July 2018 Posted By: Dr. Richard Carr

Follicular SCC?

I agree with follicular SCC

Agree with Colleagues.

Thanks for the unanimous response for follicular SCC. I think this is the most common type of squamous cell carcinoma but this case illustrates the features so well that even the sceptics might agree. The tumour can very closely mimic keratoacanthoma clinically, especially, at this location and may have rapid growth in our experience. This type of lesion has been reported as "crateriform" SCC. The important distinguishing features in this case are the more pushing borders with slight tendency to palisading and the "spontaneous" acantholysis as opposed to focal acantholysis limited to central neutrophil microabscesses seen in KA. Obviously a few cases can be hard to pigeon hole so best to admit uncertainty if unsure. In KA the borders are more infiltrative with identifiable elastic and collagen entrapment, highly pleomorphic and mitotically active in the peripheral few cells layers but with full and often fairly abrupt maturation in all areas. KA lack central acantholytic mucin pools typical of many follicular SCC. For more on the topic google: YouTube Derm talks, follicular squamous cell carcinoma, Carr and share the link with friends

Beautiful one!