Abstract

We report an unusual case of spindle cell squamous cell carcinoma with Cytokeratin-Positive multinucleated giant cells. A 79-year-old male with a past medical history significant for melanoma-in-situ and multiple non-melanoma skin cancers presented to Dermatology Clinic with a smooth papule on the crown of the scalp. A biopsy was performed and revealed a dermis infiltrated by atypical spindle cells and multinucleated cells. Both spindle and multinucleated cells expressed strong and diffuse Cytokeratin AE1/AE3 and p63 (did not show a biphasic staining pattern between multinucleate and spindle cells). The cells were negative for Sox-10, HMB-45, S-100, Melan-A, CD31, EMA and Desmin. CD68 stained dermal dendritic cells within the tumor and a subpopulation of the spindle cells, but not the multinucleate giant cells. Faint Smooth Muscle Actin and CD10 highlighted the lesional cells (a feature of some spindle cell squamous cell carcinomas). We present this case as an unusual variant of spindle cell squamous cell carcinoma, and to contrast with cutaneous squamous cell carcinoma with osteoclast-like giant cells.

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