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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 1312 - 03 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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1cm soft cystic swelling on forehead ?sebaceous cyst

Case posted by Dr Richard Carr


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Dr. Richard Carr

Posted

This is from a male of 53 years

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Dr. Mona Abdel-Halim

Posted

Metaplastic synovial cyst.

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Guest Romualdo

Posted

Yes: metaplastic synovial cyst.

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Eman El-Nabarawy

Posted

Cutaneous metaplastic synovial cyst.

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Dr. Richard Carr

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case%201312%20-%20RAC7159x10_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case%201312%20-%20RAC7159x20_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case%201312%20-%20RAC7159x40_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case%201312%20-%20RAC7159x5b_4pm.jpg[/img]

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Dr. Mona Abdel-Halim

Posted

OMG :-))
So it is just a cystic BCC that fell out ..
I thought of this when Dr Carr said try again !!!! Was going to suggest it but the outline of the cavity (festooning outline) was holding me back !!!
Looking again to the initial images I think the mucin in the last image should have been taken as a clue ...
Lovely :-))

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Dr. Richard Carr

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case%201312%20-%20RAC7159x5_BerEP4_5pm.jpg[/img]

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Dr. Mona Abdel-Halim

Posted

Just amazing :-))

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Dr. Richard Carr

Posted

Yes I agree it is a terrible trick but I can assure you several years ago I reviewed a biopsy from the foot (not a common site for BCC) in which the report read roughly as follows: "Dermal cyst and a separate carry-over of nodular BCC". On review the cyst had a mucinous stroma but no epithelial lining and the so-called carry-over was a similar shape to the hole in the dermis! I have recorded two further examples in my database in which I reported punch biopsies from the face clinically ?BCC with just a mucinous pseudocyst such as this and could not find the BCC despite levels through the block - I reported the biopsies as most likely a BCC that has "dropped-out". It is a trick well to remember!

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