As a first step, on FCM images it was possible to understand the epithelial origin of the tumor because of the presence of fluorescent tumoral structures forming cords or single cells located in the mid-dermis. Of note, the neoplastic proliferations did not show any peripheral palisading. Although an exact diagnosis of ESC was not possible in case 1 owing to the rarity of the tumor and thus the relatively scarce experience of the FCM reader, the lesion was provisionally identified as an epithelial tumor. Interestingly, case 2 was correctly diagnosed as ESC on FCM. As a second step, the clearance of the margins was easily assessed on FCM.