PMC6854162_01
Posterior cranium exhibiting a large exophytic mass.
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On physical examination, a 6.0 cm exophytic mass is found on the left occipital scalp (Figure 1).
Verrucous Carcinoma. Marked digitated acanthosis of is associated with bulbous aggregates of squamous epithelium, producing a pushing border. Cytologic atypia was minimal. A focus of SCAP is present at the lower left 20x.
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On histopathologic examination, a large verrucous proliferation comprised of stratified squamous epithelium with slight atypia is seen (Figure 2).
SCAP. Columnar epithelial cells with decapitation secretion line a papillated structure. A myoepithelial cell layer was present. The stroma contains numerous plasma cells 20x.
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These findings show that a large verrucous proliferation is present along with an "incidental" syringocystadenoma papilliferum (Figure 3).
BCC. Aggregates of basaloid epithelial cells with peripheral palisading and central necrosis 200x.
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Additionally, there is a focal associated nodular basal cell carcinoma (Figure 4).