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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1208 - 09 February 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 21 year old woman with an excision with margin exam of a darkening lesion present 8 years on the lateral aspect of the left breast.

Case posted by Dr Mark Hurt

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Guest Jim Davie MD


Agree with combined nevus (common and balloon cell nevus).

I look at these twice, as the differential would include balloon-cell melanoma, which may have deceptively bland nuclear features, and/or arise in a benign nevus, so as to conceal its true nature. The symmetrical wedge pattern and pattern of infiltration, and absence of expansile nodules or mitotic activity, are reassuring.

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Mark A. Hurt MD


Yes, this is a superficial congenital melanocytic nevus with balloon cell melanocytes. Jim's points are well taken about balloon cell melanoma -- so beware! In this particular case, I scanned the lesion at 40x on several fields, and there are no mitotic figures. This, and the pattern of grown, clinch the diagnosis.

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