Case Number : Case 2268 - 21 February 2019 Posted By: Raul Perret

Metaplastic SCC. 

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

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

like to add melanoma.

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

Waiting for the brown stains.

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. 

Nice case.

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.