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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 981 - 27th March Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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The patient is a 7 year-old female with pigmented right shoulder lesion.

Case posted by Dr. Hafeez Diwan.


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Dr. Mona Abdel-Halim

Posted

Pigmented epithelioid melanocytoma

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Heavly pigmented melanocytic lesion with epithelioid melanocytes and melanophages. Figure 3 shows a component of cellular blue nevus. I think this is a lesion within a spectrum of Pigmented cellular blue nevus and Pigmented epithelioid melanocytoma. I would recommend excision with margins and consider the possibility of association with Carney´s syndrome. I would have to look into the literature for sentinel lymph node biopsy, I don´t have the answer roght now, but I think it is controvertial.

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Eman El-Nabarawy

Posted

Agree with Dr Mona. .Pigmented epithelioid melanocytoma. .

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Robledo F. Rocha

Posted

Melanocytic lesion comprising pigmented epithelioid cells admixed with pigment-laden macrophages and dendritic cells. There’s also pseudoepitheliomatous hyperplasia of the epidermis. Those features suggest combination of Spitz nevus and blue nevus. Nonetheless, due to high cellularity, impaired maturation with depth, deep pigmentation, prominent nucleoli, and brisk mitotic activity, I think this is melanoma arising within a congenital nevus.

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Dr. Hafeez Diwan

Posted

I called this pigmented epithelioid melanocytoma, and advised complete excision + sentinel nodes.

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