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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 2268 - 21 February 2019 Posted By: Raul Perret

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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57y old male cheek lesion


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Krishnakumar subramanian

Posted

like vascularized tumor with combination of spindle cells and deep dermal involvement

like to see Cd31 and FLi-1 stain pattern -r/o angiosarcoma.

 

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Alex-Ventura-Leon

Posted

Favor SCC, but the differential include AFX, Melanoma and less like (for me) Angiosarcoma.

Waiting for the brown stains.

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Raul Perret

Posted

Good suggestions everyone. If you check the morphology, the tumor is originating from the epidermis so there are basically 2 main differentials to consider: A) Carcinoma poorly dif/sarcomatoid B) Melanoma. A dual marker panel with p63 and PS100 or sox10 solves the problem. Most important thing in our jobs is morphology and it should guide the selection of ancillary techniques. Depending on the setting, asking too many markers/molecular tests can be as bad as asking too few. 

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On 21/02/2019 at 12:29, Raul Perret said:

Good suggestions everyone. If you check the morphology, the tumor is originating from the epidermis so there are basically 2 main differentials to consider: A) Carcinoma poorly dif/sarcomatoid B) Melanoma. A dual marker panel with p63 and PS100 or sox10 solves the problem. Most important thing in our jobs is morphology and it should guide the selection of ancillary techniques. Depending on the setting, asking too many markers/molecular tests can be as bad as asking too few. 

Well said, thanks again Raul for another nice case.

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