FIGURE 1 - uploaded by Etan Marks
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A) Hematoxylin and eosin (H&E) stain 10x original biopsy showing basal cell carcinoma. B) 2x Mohs specimen showing deep focus of sebaceous carcinoma and superficial remnant of basal cell carcinoma. C,D) 20x and 40x of sebaceous carcinoma. E) 10x of residual basal cell carcinoma.
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Collision tumors are neoplasms composed of two or more distinct cellular lineages coexisting at the same anatomic site. Incomplete biopsy, partial pathological slide examination or failure to include this diagnosis into the clinical differential may complicate and delay appropriate therapy. Although collision tumors are well documented, basal cell...
Contexts in source publication
Context 1
... 76-year-old male with a history of BCC and squamous cell carcinoma presented to clinic for Mohs micrographic surgery to extirpate a biopsy-proven BCC, two weeks after initial biopsy ( Figure 1A). Mohs surgery was performed with frozen sections, and the first stage revealed atypical basaloid cells surrounding atypical foamy cells with scalloped nuclei at the deep margin, concerning for SC ( Figures 1B-1D). ...
Context 2
... 76-year-old male with a history of BCC and squamous cell carcinoma presented to clinic for Mohs micrographic surgery to extirpate a biopsy-proven BCC, two weeks after initial biopsy ( Figure 1A). Mohs surgery was performed with frozen sections, and the first stage revealed atypical basaloid cells surrounding atypical foamy cells with scalloped nuclei at the deep margin, concerning for SC ( Figures 1B-1D). The atypical cells were cleared on the second stage, leaving a 2.2 x 1.4 cm surgical defect size. ...
Context 3
... SC was favored, given the equivocal pathology on frozen section (BCC with adnexal differentiation vs SC), these slides were sent to dermatopathology for tumor confirmation. A dermatopathologist re-examined the initial biopsy slide, and confirmed nodular BCC alone to be present, as seen in Figure 1A, with morphologic features being distinct and different from the sebaceous carcinoma ( Figures 1B-1D). The first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. ...
Context 4
... SC was favored, given the equivocal pathology on frozen section (BCC with adnexal differentiation vs SC), these slides were sent to dermatopathology for tumor confirmation. A dermatopathologist re-examined the initial biopsy slide, and confirmed nodular BCC alone to be present, as seen in Figure 1A, with morphologic features being distinct and different from the sebaceous carcinoma ( Figures 1B-1D). The first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. ...
Context 5
... first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. SC at the deep margin was confirmed as seen in Figures 1B-1D, as well the presence of a separate focus of BCC extending into the superficial dermis, as seen in Figure 1B and Figure 1E. The dermatopathologist agreed with the diagnosis of sebaceous carcinoma and favored this to be a collision lesion rather than a contiguous BCC with sebaceous differentiation. ...
Context 6
... first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. SC at the deep margin was confirmed as seen in Figures 1B-1D, as well the presence of a separate focus of BCC extending into the superficial dermis, as seen in Figure 1B and Figure 1E. The dermatopathologist agreed with the diagnosis of sebaceous carcinoma and favored this to be a collision lesion rather than a contiguous BCC with sebaceous differentiation. ...
Context 7
... first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. SC at the deep margin was confirmed as seen in Figures 1B-1D, as well the presence of a separate focus of BCC extending into the superficial dermis, as seen in Figure 1B and Figure 1E. The dermatopathologist agreed with the diagnosis of sebaceous carcinoma and favored this to be a collision lesion rather than a contiguous BCC with sebaceous differentiation. ...
Context 8
... 76-year-old male with a history of BCC and squamous cell carcinoma presented to clinic for Mohs micrographic surgery to extirpate a biopsy-proven BCC, two weeks after initial biopsy ( Figure 1A). Mohs surgery was performed with frozen sections, and the first stage revealed atypical basaloid cells surrounding atypical foamy cells with scalloped nuclei at the deep margin, concerning for SC ( Figures 1B-1D). ...
Context 9
... 76-year-old male with a history of BCC and squamous cell carcinoma presented to clinic for Mohs micrographic surgery to extirpate a biopsy-proven BCC, two weeks after initial biopsy ( Figure 1A). Mohs surgery was performed with frozen sections, and the first stage revealed atypical basaloid cells surrounding atypical foamy cells with scalloped nuclei at the deep margin, concerning for SC ( Figures 1B-1D). The atypical cells were cleared on the second stage, leaving a 2.2 x 1.4 cm surgical defect size. ...
Context 10
... SC was favored, given the equivocal pathology on frozen section (BCC with adnexal differentiation vs SC), these slides were sent to dermatopathology for tumor confirmation. A dermatopathologist re-examined the initial biopsy slide, and confirmed nodular BCC alone to be present, as seen in Figure 1A, with morphologic features being distinct and different from the sebaceous carcinoma ( Figures 1B-1D). The first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. ...
Context 11
... SC was favored, given the equivocal pathology on frozen section (BCC with adnexal differentiation vs SC), these slides were sent to dermatopathology for tumor confirmation. A dermatopathologist re-examined the initial biopsy slide, and confirmed nodular BCC alone to be present, as seen in Figure 1A, with morphologic features being distinct and different from the sebaceous carcinoma ( Figures 1B-1D). The first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. ...
Context 12
... first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. SC at the deep margin was confirmed as seen in Figures 1B-1D, as well the presence of a separate focus of BCC extending into the superficial dermis, as seen in Figure 1B and Figure 1E. The dermatopathologist agreed with the diagnosis of sebaceous carcinoma and favored this to be a collision lesion rather than a contiguous BCC with sebaceous differentiation. ...
Context 13
... first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. SC at the deep margin was confirmed as seen in Figures 1B-1D, as well the presence of a separate focus of BCC extending into the superficial dermis, as seen in Figure 1B and Figure 1E. The dermatopathologist agreed with the diagnosis of sebaceous carcinoma and favored this to be a collision lesion rather than a contiguous BCC with sebaceous differentiation. ...
Context 14
... first Mohs stage was re-embedded for permanent sectioning and immunohistochemical staining. SC at the deep margin was confirmed as seen in Figures 1B-1D, as well the presence of a separate focus of BCC extending into the superficial dermis, as seen in Figure 1B and Figure 1E. The dermatopathologist agreed with the diagnosis of sebaceous carcinoma and favored this to be a collision lesion rather than a contiguous BCC with sebaceous differentiation. ...
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... This case requires that future re-excision should be performed to ensure complete elimination of the tumor. [9] In conclusion, a thorough histopathological examination of the tumor is vital to identify the second component as the prognosis varies accordingly. Our case was misinterpreted as spindle cell squamous cell carcinoma in biopsy which was later proven to be a collision tumor containing melanoma component by immunohistochemistry in the excision specimen. ...
Collision tumors are two cancers that coexist in the same anatomical site. The etiopathogenesis of collision tumors remains controversial. Even though collision is uncommon, the association between squamous cell carcinoma and malignant melanoma is very rare compared to basal cell carcinoma and malignant melanoma. Here, we report a case of squamous cell carcinoma with malignant melanoma which was confirmed by histopathological examination and immunohistochemistry. The patient underwent wide local excision and flap cover. This case is reported due to the rarity.
