Treatment

Under local anesthesia, an incisional biopsy was performed. After the incisional biopsy, the patient was referred for surgical excision of the neoplasm.

Excisional Biopsy

Histologic examination revealed multiple fragments of soft tissue composed epithelial islands of variable shapes and sizes lined by one layer of palisaded columnar cells with reversed polarization (Figures 3 & 4). The islands are filled with stellate reticulum-like epithelial cells in some areas and squamous epithelium in others (Figures 3 & 4).

Figure 3 Low power (x100) H & E histology shows epithelial islands of variable shapes and sizes lined by one layer of palisaded columnar epithelial cells with reversed polarization. The center of the islands contains stellate-reticulum-like epithelial cells in some areas and squamous in others.

Figure 4 Higher power (x200) H & E histology shows epithelial islands with one layer of palisaded columnar epithelial cells and center filled with stellate-reticulum-like epithelial cells in some areas and squamous epithelium in others.