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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 893 - 20th 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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62 year-old male with abdominal wall mass.

Case posted by Dr. Hafeez Diwan.


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Guest Dr.Yüksel Okumuş

Posted

This abdominal mass maybe due to late inflammatory and secondary hyperplastic epidermal changes after surgery.

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Guest Dr. Taskin Erkinuresin

Posted

my interpretation is adenoma sebaceum

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Guest Dr.Yüksel Okumuş

Posted

[quote name='I. Abdul-kadir' timestamp='1384940361']
Superficial angiomyxoma.
[/quote]
I think you are right.

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Sasi Attili

Posted

These superficial levels look like a superficial angiomyxoma. However we are not seeing the deeper aspect of the specimen/ lesion to exclude a low-grade fibromyxosarcoma or a myxofibrosarcoma, spreading up into the skin (though very unlikely)- particularly since the clinical description (mass) sounds worrying! However if this is a superficial lesion and the histo of the remaining part of the lesion is no more worrying, I would go with a benign Superficial angiomyxoma.

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Dr. Richard Carr

Posted

How about chronic lymphoedema as a differential? Scarring, vertical vessels, chronic inflammation, haemosiderin. Any history of surgery etc. Reminded me of the mass lesions seen in anogenital regions in chronic lymphoedema.

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Guest Juan Carlos Garcés, Ecuador

Posted

Syringofibroadenomatous hyperplasia vs Chronic lymphoedema. Happy birthday Robledo

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I think this case is a Chronic papillomatous dermatitis probably secondary to a stoma irritant contact dermatitis. The patient could have a stoma after a gastrointestinal cancer surgery.
This alteration has been described together with lymphoedema and hyperplasic epithelial changes.

There´s a nice paper by Dr. Carlson who also demonstrated HPV interacting with this alteration:
[url="http://www.ncbi.nlm.nih.gov/pubmed/22699864"]http://www.ncbi.nlm.nih.gov/pubmed/22699864[/url]

I also want to congratulate our friend Dr. Robledo for his Birthday. I wish you good health, happiness and nice dermpath cases in your life.

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Guest Romualdo

Posted

I had the same impression of Dr. Richard Carr. The histological findings did not remind me a superficial angiomyxoma. I am wondering if the patient is a morbidly obese one and the diagnosis could be elephantiasis nostras verrucosa. I think clinicopathologic correlation is absolutely necessary.

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Chronic lymphoedema with secondary pseudoepithelioumatous hyperplasia. HBD Robledo!

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Dr. Mona Abdel-Halim

Posted

Agree with Dr Carr,, Happy Birthday Robledo :-))

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Robledo F. Rocha

Posted

[color="#000000"]I'm thinking of chronic lymphedema with syringofibroadenomatous hyperplasia supported by dermal edema, mild lymphocytic perivascular infiltrate, hemosiderin deposition, and dilated thick-walled vessels arranged perpendicularly to the skin surface.[/color]

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Robledo F. Rocha

Posted

[color=#000000]Many thanks to the friends for their kind words on the occasion of my birthday.[/color]
[color=#000000]I can't like the congratulations from Garcés and Romualdo just because the icon LIKE THIS does not exist after their [/color][color=#000000]comments.[/color]

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Iskander H. Chaudhry

Posted

Dear all

Thanks for your diagnoses as always. Hafeez is away and I am stepping in to give the diagnosis. The diagnosis is ... [font=Georgia,][size=4]Elephantiasis nostras verrucosa. [/size][/font]If you want to know more about it here is a pubmed link [url="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861233/"]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861233/[/url].

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Guest Jim Davie MD

Posted

[size=4]Robledo, feliz aniversário velho![/size]

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Robledo F. Rocha

Posted

[quote name='Jim Davie MD' timestamp='1384972338']
Robledo, feliz aniversário velho!
[/quote]
Valeu, meu amigo!

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