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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 2508 - 17 February 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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76M, Excision lateral border left knee. Long standing papule x 5mm. Red fleshy smooth nodule ?


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Dr. Mona Abdel-Halim

Posted

The left side component look like MCC. The right side component could be BCC or basaloid SCC, needs higher magnification to further assess.

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Please Dr Iskander, what's the diagnosis of 2489???

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Admin_Dermpath

Posted

From Dr Chaudhry:

Thanks everyone it is a MCC next to a basaloid SCC!

The case shows a basaloid tumour which on the right shows appearances of a basaloid squamous cell carcinoma (EMA+, BerEp4-) and on the left is a dermal tumour composed of monotonous round cells with scant eosinophilic cytoplasmic rim, round and vesicular nuclei with finely granular and
dusty chromatin and multiple nucleoli. Apoptotic nuclei and frequent mitotic figures are seen (the tumour cells are positive for CD56). The diagnosis is a Merkel/ Neuroendocrine carcinoma in collision with squamous cell carcinoma. 

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