case_images: PMC9837637_01
case_images: (a) Exophytic multinodular tumor of 15 cm in diameter with a festooned edge, white-yellowish with reddish hemorrhagic areas, surrounded by an asymmetrical erythematous halo. (b) Subcutaneous palpable mass, tough, of 5 cm diameter located in left axillae.
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case_images: The lesion was exophytic, multinodular, with reddish and white-yellowish areas (Fig. 1). Fine needle aspiration of a palpable left axillary mass showed histological findings similar to those described before (Fig. 1).
case_images: (a) On the upper pole of the giant mass can be observed a greyish bright area different from the rest of the periphery. (b) Dermoscopy of the upper pole revealing a flatter milky red area with whitish regression areas and ovoid nests. (c) Light microscopy with basaloid cells with scant cytoplasm and elongated hyperchromatic nuclei, peripheral palisading and peritumoral clefting, (Hematoxylin & eosin, x100).
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case_images: At the upper pole of the tumor, there was a flatter milky red area with regression areas and ovoid nests on dermoscopy, which was histologically confirmed as a basal cell carcinoma (BCC) (Fig. 2 a-c).
case_images: (a) Sheets of atypical and pleomorphic cells with numerous mitoses and necrotic areas. The tumor cells have prominent nucleolus, excentric cytoplasm with a nucleous/cytoplasm disproportion. Tumor cells stained positively for CD163 (x400) (b), Lisozime (x400) (c), and CD68 (x400) (d).
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case_images: A biopsy of the most voluminous tumor (Fig. 3a) showed dermal sheets of atypical pleomorphic cells. Tumor cells stained positively for CD68, CD163, CD45, lysozyme (Fig. 3 b-d), and vimentin, and were negative for lymphoid, dendritic, epithelial, and melanocytic markers.