a Numerous keratinous cysts and small islands of basaloid and squamous epithelium with ductal differentiation throughout the superficial to deep dermis. In addition, smaller nests and strands of cells in a desmoplastic stroma (b) with nerve invasion (c, d) are prominent in the deep dermis (hematoxylin and eosin staining (a-c), S100 staining (d)) (scale bar, 200 μm (a) and 100 μm (b-d)).

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... (Fig. 1a). Dermoscopy showed a whitish mesh-like structure with arborizing vessels (Fig. 1b). MRI findings suggested tumor infiltrating into the latissimus dorsi (Fig. 1c). A biopsy specimen showed numerous keratinous cysts and small islands of basaloid and squamous epithelium with ductal differentiation throughout the superficial to deep dermis (Fig. 2a). In addition, smaller nests and strands of cells in a desmoplastic stroma (Fig. 2b) with nerve invasion (Fig. 2c, d) were prominent in the deep dermis. On immunohistochemical staining, these tumor cells were positive for AE1/AE3 and negative for CEA and BerEP4. From the above findings, the diagnosis was MAC on the back with nerve ...

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... (Fig. 1b). MRI findings suggested tumor infiltrating into the latissimus dorsi (Fig. 1c). A biopsy specimen showed numerous keratinous cysts and small islands of basaloid and squamous epithelium with ductal differentiation throughout the superficial to deep dermis (Fig. 2a). In addition, smaller nests and strands of cells in a desmoplastic stroma (Fig. 2b) with nerve invasion (Fig. 2c, d) were prominent in the deep dermis. On immunohistochemical staining, these tumor cells were positive for AE1/AE3 and negative for CEA and BerEP4. From the above findings, the diagnosis was MAC on the back with nerve invasion. The tumor was excised with a 30-mm margin and part of the latissimus dorsi and ...

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... tumor infiltrating into the latissimus dorsi (Fig. 1c). A biopsy specimen showed numerous keratinous cysts and small islands of basaloid and squamous epithelium with ductal differentiation throughout the superficial to deep dermis (Fig. 2a). In addition, smaller nests and strands of cells in a desmoplastic stroma (Fig. 2b) with nerve invasion (Fig. 2c, d) were prominent in the deep dermis. On immunohistochemical staining, these tumor cells were positive for AE1/AE3 and negative for CEA and BerEP4. From the above findings, the diagnosis was MAC on the back with nerve invasion. The tumor was excised with a 30-mm margin and part of the latissimus dorsi and trapezius muscles. In addition to ...