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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 892 - 19th November 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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The patient is a 67 year old white man with a shave biopsy of a 4 mm skin-colored papule with telangiectasia taken from the right, lateral aspect of the chin.

Case posted by Dr. Mark Hurt


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Guest Dr.Yüksel Okumuş

Posted

Agree with solitary circumscribed neuroma (palisaded encapsulated neuroma)

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Sasi Attili

Posted

[quote name='Guest' timestamp='1384856789']
solitary circumscribed neuroma
[/quote] agree

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Robledo F. Rocha

Posted

Palisaded encapsulated neuroma (solitary circumscribed neuroma).

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Guest Juan Carlos Garcés, Ecuador

Posted

[b]Agree with Palisadee encapsulated neuroma[/b]

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Guest Jim Davie MD

Posted

Agree with palisaded encapsulated neuroma (or, [i]solitary circumscribed neuroma[/i], for those who rightly complain that palisaded encapsulated neuromas are often neither...).

Subtle poorly formed Verocay bodies and scattered mast cells are present. Perfunctory differential would include schwannoma (unlikely) or neurofibroma (too circumscribed).

[i]Stanford Univ Surgical Pathology site has a succinct table of immunohistochemical and histologic features for differentiating PEN vs. schwannoma vs. NF:[/i]
[url="http://surgpathcriteria.stanford.edu/peripheral-nerve/solitary-circumscribed-palisaded-encapsulated-neuroma/printable.html"]Solitary Circumscribed Neuroma[/url]

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Dr. Mona Abdel-Halim

Posted

Very beautiful solitary encapsulated neuroma

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Mark A. Hurt MD

Posted

My diagnosis was solitary circumscribed neuroma.

I consider this one of two common "grape nuts" tumors. This one is neither palisaded nor encapsulated. The other is "pyogenic granuloma," which is neither fundamentally pyogenic nor granulomatous. Why "grape nuts?" It is a cereal that is composed of neither grapes nor nuts.

Ref:

Fletcher CD. Solitary circumscribed neuroma of the skin (so-called palisaded, encapsulated neuroma). A clinicopathologic and immunohistochemical study. Am J Surg Pathol. 1989 Jul;13(7):574-80. PubMed PMID: 2660609.

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