Case Number : Case 2897 - 13 August 2021 Posted By: Dr. Richard Carr

Primary cutaneous apocine carcinoma (I can see a layer of myoepithelial cells ?P63) after exclusion of metastatic adenocarcinoma. 

dermal infiltrative tumor, multiple islands of tumor cells having ducts

malignant adenocarcinoma

Primary of malignant based on clinical information and IHC for p63 and ck7

primarily dermal tumour, pleomorphism , some apoptotic cells, i think there are ducts- i would be keen to r/o metastatic adenocarcinoma

This lesion was diffusely ER and GCDFP15 +ve. No p63 myoepithelial layer in fact this curious pattern has been described as the "applique" sign in sebaceous carcinomas by Kazakov it seems a peripheral arrangement of rather compressed or degenerate appearing cells at the stromal interface. Clearly it's not specific as this was thought to be a breast carcinoma (or less likely a cutaneous adnexal equivalent) most likely, either way the management is as for breast carcinoma (actually the clnical query which I withheld). There are small duct lumina as observed above.