case_images: PMC10986867_01
case_images: (a) An ulceroproliferative nodule on left temporal region (b) Present day (four years post-op) clinical picture showing disease free status
case_images: IJD-69-77-g001.jpg
case_images: PMC10986867_01_IJD-69-77-g001.jpg
case_images: ijd_243_23-f001
case_images: On physical examination a reddish friable ulcerated exophytic growth of size 2.5 x 2.1 x 1.5 cm was seen on the left temporal region [Figure 1a]. After four years also the patient remains disease free [Figure 1b].
case_images: (a) HPE showing a cutaneous tumour (HE 40x) (b) HPE showing a biphasic tumour with epithelial and mesenchymal components, both with malignant features (HE 100x) (c-f) IHC showing epithelial component exclusively positive for CK5/6 (c), mesenchymal component exclusively positive for vimentin (d), both components variably positive for D2-40 (e and f)
case_images: IJD-69-77-g002.jpg
case_images: PMC10986867_01_IJD-69-77-g002.jpg
case_images: ijd_243_23-f002
case_images: The incisional biopsy showed a biphasic tumour: with epithelial component consisting of anastomosing cords of basaloid cells with peripheral pallisading separated by a cellular spindle cell stroma showing severely pleomorphic nuclei: basal cell carcinoma with sarcomatous stroma i.e., primary cutaneous carcinomasarcoma (PCCS) [Figure 2a and b]. The epithelial and stromal component marked exclusively for pancytokeratin (AE1/AE3) CK5 and 6/p40 and vimentin respectively [Figure 2c and d] Both components were immunopositive for D2-40 and immunonegative for BerEP4/S100/Melan A/MITF [Figure 2e and f] Thus, final diagnosis kept was Trichoblastic carcinosarcoma.