F6Ch16: The rounded nest in the center of the field is composed of basaloid cells; there is mild atypia with variation in nuclear size, outline, and staining. The central rounded nest is attached superiorly to a strand of squamous cells. In turn, there appears to be a single row of flattened squamous cells that outline the rounded nest . The myxoid stroma bulges irregularly into the epithelial component.
A diagnosis of melanoacanthoma might be considered in areas in which tumor cells are pigmented. Such a diagnosis offers little in the way of guides to therapy. In my experience, the diagnosis merely encourages a clinician to be more aggressive.