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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 2731 - 24 December 2020 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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86M
Left scalp C&C. 4mm papule. Rolled edge. Arborising vessels


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Krishnakumar subramanian

Posted

epithelioid hemangioma

However considering the age i am concerned with angiosarcoma

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On 26/12/2020 at 06:17, Krishnakumar subramanian said:

epithelioid hemangioma

However considering the age i am concerned with angiosarcoma

Agree, and would like to see a pan keratin stain/Erg to rule out SCC or a METASTATIC LUNG ADENOCARCINOMA( adenosquamous). 

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Iskander H. Chaudhry

Posted

Dear All 

Thanks for your comments! Seasons greetings. As you say this is a tumour showing mild acanthosis and dermal islands of eosinophil epithelioid cells with clear cell change and myxoid stroma. The tumour cells show prominent nucleoli and mitotic activity. The tumour is positive for MNF116 and CK7 with membranous staining. It is negative for CD31, CEA, SMA, Desmin and S100. No lympho-vascular or perineural invasion is seen. There is no tumour necrosis. No epidermal changes are evident.

I classified this as a primary cutaneous carcinoma (likely adnexal) versus metastatic carcinoma.

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Nice but Tricky case. Given the growth pattern, I do entertain the possibility of cutaneous adnexal carcinoma such as squamoid eccrine ductal carcinoma 

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