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Patient Case Studies

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Histology

Diagnosis change: AFX to Pleomorphic Sarcoma of Neck

  HISTORY 93-year-old man presents with an incidentally discovered left neck mass during evaluation of a left ear SCC. Initial biopsy on 9-5-17 showed atypical fibroxanthoma. Excision of the left neck lesion with 5 mm margins on 9-26-17 revealed malignant spindle and epithelioid cell neoplasm consistent with pleomorphic dermal sarcoma. Deep and peripheral margins were…

INFLAMED SK APPEARING AS SQUAMOUS CELL CARCINOMA

HISTORY 57-year-old woman with 40-year history of growth on right mid back that has changed in color and size. This is a 2.2cm rough plaque with variable colors. Previous biopsy done 15-20 years ago was benign. Patient has a history of BCC and SCC. Biopsy  was read as a squamous cell carcinoma by a dermatologist.…

LOWER LIP ATYPIA AT MARGINS OF SQUAMOUS CELL CARCINOMA

HISTORY 89-year-old man presents with several month history of lesion on bottom lip. A biopsy was taken on 8-9-17 and showed severe squamous atypia without ruling out deeper SCC. Excision of lesion done 9-6-17 showed invasive squamous cell carcinoma with foci of moderate squamous dysplasia from 9 to 3 o’clock. Patient has history of BCC,…

RECURRENT MELANOMA

  HISTORY 70-year-old woman presents with metastatic melanoma in the right parotid gland region of 1 year duration. Diagnosis was made with a core needle biopsy on 09-08-17. Patient also has small palpable right cervical lymph nodes with SUV 1.6 and 2.0. Patient history of melanoma began in 2001 as a pink macule of the…

CHEEK AND EYELID RECONSTRUCTION WITH MULTIPLE PARTIAL ISLAND FLAPS

HISTORY 61-year-old woman presents with several year history of pigmented left cheek and lower lid lesion.  She was initially treated with liquid nitrogen 15 months ago. A biopsy was performed 6-8-17 and revealed melanoma in situ. Excision with close margins performed 6-16-17. Clear margins found on LPMG reading. Second opinion from UCSD was suspicious for…

MULTIPLE ATYPICAL NEVI WITH STRONG FAMILY HISTORY OF CANCER

HISTORY 24-year-old woman presents with multiple atypical nevi.  Almost all lesions had mild atypia, few had focally moderate atypia, and one on her right posterior shoulder had severe atypia and was excised with 5mm margins elsewhere. Family history is significant for melanoma in grandmother and pancreatic cancer in her father. Physical exam showed multiple 2-4…

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