Case Number : Case 1850 - 30 June - Dr Richard A Carr Posted By: Guest

Dr Richard A Carr wraps up June with a bumper set of images, enjoy.

Geoff Cross - DermpathPRO Projects

thinking on the lines of mucinous carcinoma (to exclude metastasis), wondered if there is some chondroid material in image 7 and rather plasmacytoid cells in image 11- ?malignant chondroid syringoma...epithelial and myoepthelial markers...

In a tumor with this morphology, infiltrative, with ductal, myoepithelial and squamoid differentiation as well as hyaline, osteoid like areas I would agree with malignant mixed tumor

I was thinking of a metastatic (?breast) cancer, with the "metaplastic carcinoma" features. There is a neoplastic intravascular trombosis in fig 3. But Raul's and Urmilapandey's spot is a good diff.

I thought of malignant mixed tumor

Porocarcinoma

I called this benign mixed tumour (chondroid syringoma). The necrosis was limited to the superficial aspect (most likely due to pressure necrosis or local trauma). The lesion lacked mitotic activity or cellular pleomorphism and peripheral borders were relatively circumscribed (not well shown in these images). I think the clinical history can be misleading, particularly in the elderly. There are tubular areas with pseudoinfiltrative pattern within the main bulk of the lesion. We've discussed previously how hidradenomas on the ventral surfaces of the feet can show rather infiltrative like patterns and I interpreted this as a similar phenomenon in this otherwise benign appearing lesion.