We report a case of a 63-year-old man with a history of numerous basal cell carcinomas (BCCs) on vismodegib who developed a pink subcutaneous nodule that was thought to be either a BCC or an epidermal inclusion cyst. Sections displayed a dome-shaped lesion composed of large dermal nodules of epithelioid cells with variable cytology. Some of the dermal nodules demonstrated squamatization of the epithelioid cells while others had a predominantly basaloid phenotype. Central necrosis was present in the majority of the large dermal nodules, but the lesion did not stain with CK7 or CK20, helping to rule out internal metastases. The epithelial nodules stained strongly with pancytokeratin (AE1/AE3), p40, and stained lightly with BCL-2, supporting the diagnosis of BCC. However, Ber-EP4 being negative and the presence of significant squamatization suggest vismodegib can alter both the histological and immunophenotype of BCCs. This phenomenon has rarely been reported in literature. 

Takayasu arteritis is a rare vasculitis commonly seen in young women. Amaurosis fugax and headache are visual presentations of Takayasu arteritis. Migraine with visual aura is a common condition affecting young women, and differentiating migraine from Takayasu presenting with visual symptoms and headache can be challenging. We present a case of a young woman initially misdiagnosed with migraine with aura, who was later found to have Amaurosis fugax as an early manifestation of Takayasu arteritis.

Saturday Mammography Spa Day for Grapevine-Colleyville ISD Team Members. This is a private time for team members at GCISD to receive a lifesaving mammogram.

An in-depth weight loss surgery seminar with information presented by one of our bariatric surgeons on surgical options, risks, follow-up, and monitoring requirements. A nutrition class is also provided by our dietician.