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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 2711 - 26 November 2020 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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76F, lesion right upper lip – Courtesy of Luiza Elena and Corrado D’Arrigo.


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BCC, probably infundibular variant, with an odd signet ring cell component. Very intriguing lesion. 

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DR NADINE BURKE

Posted

collision tumour?BCC and balloon cell naevus.I would do s100/mel a

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Krishnakumar subramanian

Posted

BCC with another tumor ? collision tumor

really dont know

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Cem Leblebici

Posted

Signet-ring clear cell basal cell carcinoma. I wonder whether this tumor shows myoepithelial differentiation.

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Richard Logan

Posted

Mixed micro-nodular BCC and granular cell variant of BCC.  Looks similar to case 564 posted on 7th August 2012.

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Victor Delgado

Posted

Nodular BCC with some kind of granular cell differentiation.

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Saleem Taibjee

Posted

Yes, I thought that this best fits for BCC with granular cell change. The cytoplasm is definitely granular rather than just clear, although perhaps such cases fall on a spectrum.

This must be extremely rare. I do not recall seeing such a case previously.

The case looks very similar to this published case https://pubmed.ncbi.nlm.nih.gov/24247582/ and is even more striking compared to the case which Richard points out was posted in 2012. In the published case the cells were positive for BerEP4 and CD68. However, I must admit that we did not run any immunos in the current case. The nuclei seem identical to the more conventional BCC areas, hence I was not considering a collision (e.g. melanocytic lesion, etc). BW Saleem

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