Jump to content
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 1438- 28 December Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

Case History: The patient is a 70 year old man with a shave biopsy of a 0.8 cm red papule taken from the left upper arm.

Case posted by Dr Mark Hurt


  Report Record

User Feedback


vincenzo polizzi

Posted

The silhouette looks like a keratoacanthoma with basaloid and sebaceous differentiation. Atypical site for a sebaceoma, my first diagnosis, and some beyond border atypia. So i'm thinking to a "low grade sebaceous carcinoma developed in sebaceoma"

Share this comment


Link to comment
Share on other sites

Raul Perret

Posted

I would suggest a sebaceoma with atypical features and I would state the exact mitotic activity. As the tumor is superficial, has pushing borders, is smaller tan 1 cm. and the surgical margins are free it would be important also to state that metastatic potential is around 0% on the report

Share this comment


Link to comment
Share on other sites

Mark A. Hurt MD

Posted

I figured that there would be disagreement on this one.  Here is my diagnosis:

 

-- SEBACEOUS CARCINOMA, MODERATELY DIFFERENTIATED

COMMENT:  I do believe there is a loss of PMS2 in this lesion.  There is some diminution of MLH-1, but some areas of it seem to be positive.  Consideration for the possibility of the Muir-Torre syndrome should be entertained on this basis.

 

This lesion from the left upper arm consists of a sebaceous gland neoplasm characterized by asymmetry and some degree of internal heterogeneity.  There is a fairly prominent germinative component to the lesion with a minor degree of terminal differentiation in lobules.  These basophilic germinative cells have some degree of nuclear pleomorphism with mitotic figures found relatively easily and with some nuclear overlapping.  Immunohistochemically, this lesion is negative with PMS-2 and mostly negative with MLH-1, although there are arguably areas within it of positivity.  There is no loss of MSH-2 or MSH-6 in the lesion.

Share this comment


Link to comment
Share on other sites



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...