Epithelioid Angiosarcoma

    59 year old diabetic S/P renal transplant with non-functioning AV fistula.

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    Verrucous carcinoma

    70 year old man with 4 cm hyperkeratotic nodule on plantar surface of foot. MRI showed extension into soft tissue closely approaching the tarsal bones. Superficial shave biopsy showed features of verruca vulgaris, but the lesion was transected. Based on high index of clinical concern, a partial amputation was performed.

    Metastatic colonic adenocarcinoma (Sister Mary Joseph nodule)

    65 year old man with new periumbilical skin nodule. This is a punch biopsy that is tangentially sectioned accounting for the odd shape of the tissue at low power.

    Epithelioid subcutaneous neoplasm in a 16 year old boy: A real treat.

    The patient was a 16 year old boy with presented with a well-circumscribed subcutaneous lump on the shoulder. The surgeon suspected a cyst or a lipoma. During attempted excision he recognized that this is "something else" and performed diagnostic biopsy.

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    Hypopigmented mycosis fungoides

    14 year old African American male with hypopigmented patches on the trunk for 2 years.

    Hypertrophic actinic keratosis with adjacent (incidental) epidermodysplasia verruciformis

    Scaly papule on arm of 70 year old white male. The first image shows a hypertrophic actinic keratosis displaying a nice example of the "flag sign" (sharply alternating orthokeratosis and parakeratosis). Images 2-4 show an incidental finding in the skin immediately adjacent to the actinic keratosis. The blue-gray sqamous cells accompanied by hypergranulosis represent epidermodysplasia verruciformis due to infection with HPV types 5 and/or 8.

    Superinfected case of Mycosis fungoides with S.aureus

    A 54 year-old Caucasian man had a three-year history of pagetoid reticulosis MF variant with initial IIB stage. Tumor lesions achieved a complete response with radiation therapy while patches remained stable with topical bexarotene and topical steroids.

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    Painful subungual tumor incorrectly classified as squamous cell carcinoma: A diagnostic pitfall!

    The patient was a 38 year old female with a history of warts and SCC of the toe treated with amputation presenting with a painful growin tomor of the right thumb nailbed.

    The tumor was seen on Xray eroding the bone of the distal phalanx, was diagnosed as SCC and treated with amputation.

    Later on it became apparent that the patient has incontinential pigmenti.

    Was the diagnosis correct?

    Conference: 

    Protothecosis

    Elderly male with fluctuant lower leg mass x6 months. Prior to the development of the mass, the patient cut his leg on a stick in the woods. He recently completed chemotherapy for B cell lymphoma. 

    A serious diagnosis very easy to miss

    A 52 year old woman was hospitalized with acute neurological symptoms reminiscent of TIAs. The patient had not skin rash but neurologist requested a skin biopsy to rule out one of the diagnoses he considered.

    Conference: 
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