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 1885 - 18 August - Dr Richard Carr

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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M90. Temple lesion.


User Feedback


urmilapandey

Posted · Report

the superficial component connected to epidermis looks like a basal cell carcinoma. the depper component is morphologically different with some glandular/pseudoglandular areas, keratin plugs, some signet ring like cells. ? some variant of BCC ? some type of eccrine carcinoma.

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Raul Perret

Posted · Report

Berp4, EMA among other stainings could help to see if they are neoplasms originated from different clones

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Robledo F. Rocha

Posted · Report

My first impression also was collision between basal cell carcinoma and microcystic adnexal carcinoma, but the mitotic activity is too high and the nuclear morphology is not so bland as would be expected for that sweat gland tumor. Although microcystic adnexal carcinoma may rarely present high-grade features, my sense is this whole lesion is a basal cell carcinoma with micronodular growth pattern, a variant that may lack retraction clefts, and exhibit ductal and squamous differentiation.

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vincenzo polizzi

Posted · Report

The Mona's suggestion is a good differential. However, according with Robledo, this is a high grade malignancy, so what about a metastasis of lung carcinoma, with an odd induction effect?

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nick turnbull

Posted · Report

Collision. I thought about infundibular cystic bcc but it looks like the cells and layers of maturation of a Mac. And good site. That's my first thought before stains

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Sasi Attili

Posted · Report

17 hours ago, Dr. Mona Abdel Halim said:

Concomitant BCC and MAC

 

Agree

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Dr. Richard Carr

Posted · Report

Many thanks for all your comments. My final diagnosis was:

Collision of BCC and infiltrative, pseudoglandular, follicular squamous cell carcinoma.

 

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