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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 1053 - 7th July 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 65 year old white woman with a shave biopsy from the frontal scalp.

Case posted by Dr. Mark Hurt


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Dr. Mona Abdel-Halim

Posted

Yes, spiradenoma

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Mark A. Hurt MD

Posted

Here are the follow-up images from an excision in the same location. Now what do you think?

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1053_Image%2005.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1053_Image%2006.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1053_Image%2007.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1053_Image%2008.jpg[/img]

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Robledo F. Rocha

Posted

Spiradenocylindroma.

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Guest Jim Davie MD

Posted

Infiltrative variant of spiradenoma.

(same cytology and nest architecture as original, no atypia/mitoses/inflammatory reaction).
In cases of rare malignant degeneration to spiradenocarcinoma, there is usually significant cytologic atypia, mitotic activity and/or necrosis.

Occasional infiltration into subcutaneous tissue has been described in spiradenoma.
[font=tahoma,geneva,sans-serif][ a case report with photos (free access): [/font]
[font=tahoma,geneva,sans-serif]Dermatol Surg. Nov 2013; 39(11): 1711–1714. [url="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065362/"]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065362/[/url] ][/font]

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Mark A. Hurt MD

Posted

My composite diagnosis was cylindrospiradenoma. I appreciate Jim's reference, but I have to admit I am somewhat skeptical about this entire lesion as spiradenoma, as the prominent basement membrane thickening is so characteristic of cylindroma in the second case.

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