This fascinating tumor is certainly a rare bird and, like rare birds, it seems to have multiple names: carcinosarcoma, metaplastic carcinoma, carcinoma with sarcomatous component. Take your pick. This lesion comes around once or twice a decade in our practice and was my first case. There is a biphasic proliferation of malignant epithelial and mesenchymal components. The epithelial component shows changes of superficial and solid-type basal cell carcinoma. The basal cell carcinoma component shows intimate association with a spindle cell proliferation that has a somewhat storiform pattern. The spindle cell proliferation also forms a nodule of cells that show nuclear hyperchromasia, pleomorphism and brisk mitotic activity with some atypical mitotic figures. Immunohistochemistry studies showed no staining with epithelial markers in the sarcomatous component.