Forehead squamous cell carcinoma and parotid Warthin tumour
Lesion in salivary gland on ultrasound.
CT Neck (C+)
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MICROSCOPIC DESCRIPTION: 1. Sections show a well-demarcated, thinly encapsulated proliferation of oncocytic cells forming cysts and papillae within a stroma heavily infiltrated by a polymorphous population of bland lymphocytes. The lesion is fully excised. There is no evidence of malignancy. Adjacent salivary gland is unremarkable. 2. Sections show ulcerated sun damaged skin with attached subcutis and deep fascia. There is a poorly differentiated carcinoma extending from the ulcer base as solid sheets that invade subcuticular fat and skeletal muscle. The tumour does not invade through the deep fibrous fascia. Tumour cells are pleomorphic with large nucleoli containing prominent nucleoli and frequent mitotic figures. There is focal keratinisation and occasional intercellular bridges. Tumour invades nerves but lymphovascular invasion is not seen. The tumour is well clear of the skin margins. Sections of bone show no evidence of tumour.
1. Left parotidectomy: Warthin's tumour, completely excised.
2. Scalp lesion: Poorly differentiated squamous cell carcinoma invading the aponeurotic layer, not involving bone, well clear of skin and soft tissue margins.