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Presented by Peter Illei, M.D. and prepared by Julie M. Wu, M.D.
Case 2: 72 y.o. white male patient with history of squamous cell carcinoma of the face.
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Question 1 of 1
1. Question
Week 333: Case 2
72 y.o. white male patient with history of squamous cell carcinoma of the face presented with new nodule in the area of excision./images/jmw120307/5.1.jpg
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/images/jmw120307/5.5.jpgCorrect
Answer: Recurrent invasive squamous cell carcinoma
Histology: This sun damaged skin shows chronic inflammation and a proliferation of atypical epithelioid cells that form stellate structures within the dermis. Hobnail-like cells and more solid areas are also identified. In other areas (not depicted on the original images) the tumor cells show squamous differentiation. Immunohistochemistry demonstrates that the atypical cells are cytokeratin (AE1/AE3) positive and CD34 negative consistent with a recurrent squamous cell carcinoma.
Discussion: The branching and dilated structures resemble a high grade angiosarcoma, however, the more solid areas exhibit clearly identifiable squamous differentiation, thus these features are most consistent with a recurrent sarcomatoid squamous cell carcinoma.
Incorrect
Answer: Recurrent invasive squamous cell carcinoma
Histology: This sun damaged skin shows chronic inflammation and a proliferation of atypical epithelioid cells that form stellate structures within the dermis. Hobnail-like cells and more solid areas are also identified. In other areas (not depicted on the original images) the tumor cells show squamous differentiation. Immunohistochemistry demonstrates that the atypical cells are cytokeratin (AE1/AE3) positive and CD34 negative consistent with a recurrent squamous cell carcinoma.
Discussion: The branching and dilated structures resemble a high grade angiosarcoma, however, the more solid areas exhibit clearly identifiable squamous differentiation, thus these features are most consistent with a recurrent sarcomatoid squamous cell carcinoma.