In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 910 - 13th December Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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50 years old male. Cyst from back. No increasing in size.

Case posted by Dr. Richard Carr.


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Guest Jim Davie MD

Posted

Agree. Nodular hidradenoma with (not uncommon) incidental sebaceous differentiation.
The last image shows nice examples of longitudinal nuclear grooving.

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Dr. Richard Carr

Posted

Okay that was also my first impression but not my final diagnosis.

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Guest Romualdo

Posted

Dr. Richard
Did you call this neoplasm a sebaceoma based on the signs of sebaceous differentiation and the focal presence of a rippled pattern? And the nuclear and cytoplasmic features more in keeping with an hidradenoma?

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Dr. Richard Carr

Posted

Yes Romualdo the rippled pattern and basaloid areas won! So I ended up calling this a sebaceoma. I could not identify any glands or ducts at all on immunostains but I agree this lesion has many features in keeping with hidradenoma especially the central amorphous stroma and paler central areas with coffee bean nuclei highly suggestive of hidradenoma. Mis-match repair loss would have been helpful but I think we had technical difficulties with them on this case. Anyway I suggested consideration of Muir Torre. May be a unique tumour?

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Dr. Mona Abdel-Halim

Posted

As I was seeing the images in the morning, my first impression was sebaceoma based on the rippled pattern and the basaloid areas with sebocytes, until I reached the 5th and 7th images which puzzled me a lot and made me favor hidradenoma with seb differentiation,,, very nice case, glad that I have thought about it !!! .. May be if I saw the whole lesion, I would have been more confident in describing it as sebaceoma... Thank u Dr Carr:-))

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Robledo F. Rocha

Posted

[font=arial,helvetica,sans-serif]I make Mona's words my own. I even thought of a colision tumor. After all, the diagnosis brought by the last high-power pictures has prevailed.[/font]
[font=arial,helvetica,sans-serif]Thanks, Dr. Carr, for sharing. As always happens, your Friday cases make me reflect about various concepts during the weekend.[/font]

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Dr. Richard Carr

Posted

Dear Colleagues - thank you very much for the kind feedback. I have learn't so much from the contributions of all of you and feel very privileged to be able to share in this wonderful community. In view of all your opinions I did send a link to Dr Kazakov who comments at follows:
[size="3"][color="#000000"][font="Calibri"]Dear Richard[/font][/color][/size]
[size="3"][color="#000000"][font="Calibri"]Sebaceoma.[/font][/color][/size]
[size="3"][color="#000000"][font="Calibri"]My best[/font][/color][/size]
[size="3"][color="#000000"][font="Calibri"]Dmitry[/font][/color][/size]

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