The American Society of Dermatopathology


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Interactive Case Study - November 2022

A 70-year-old man with a nodular lesion on the right auricle

Aayushma Regmi, MBBS; Mario W. Saab-Chalhoub, MD; Jodi J. Speiser, MD


Question 1:

A 70-year-old man presented with a 2 year history of an asymptomatic, slowly growing nodular lesion on the posterior aspect of the right auricle. Physical examination of the auricle revealed a 0.5 cm nodule that clinically appeared to involve the underlying cartilage (Figure 1).  Wide local excision showed a 1.4 cm ulcerated nodule with the following microscopic examination (Figure. 2-7). 

Click this image to view the virtual slides.


Figure 1


Figure 2


Figure 3 


Figure 4


Figure 5


Figure 6


Figure 7


 
Which of the following is the best diagnosis?