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

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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F83. Upper chest wall. 50 x 55mm nodular plaque.


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Eman El-Nabarawy

Posted

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

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Krishnakumar subramanian

Posted

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

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

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Dr. Richard Carr

Posted

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.

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