Primary cutaneous carcinosarcoma: dermoscopic and immunohistochemical features

A 73-year-old man presented a 9-month history of an enlarging nodule on his right temple. Dermoscopy revealed a non-pigmented lesion with ulceration, fibrosis and pale globules. An excisional biopsy was carried out and histology showed a biphasic tumour with a basal cell carcinoma like epithelial component and a dermal undifferentiated sarcoma, with pleomorphic spindle cells and numerous osteoclast-like giant cells. Based on immunohistochemistry findings, a diagnosis of primary cutaneous carcinosarcoma was made and the patient underwent wide local excision.