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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 1277 - 15 May 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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F85. Supra-clavicular fossa lesion. ?SEBK

Case posted by Dr Richard Carr


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Guest Romualdo

Posted

Apocrine poroma (poroma with sebaceous differentiation).

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IgorSC

Posted

I had never seen one of this. After read about it, I agree with Apocrine poroma.

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Guest rshanesmith

Posted

Poroma with sebaceous differentiation (apocrine poroma). Not been reported to occur on plantar or palmar surfaces like usual poromas according to Kazakov's adnexal book page 30.

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Arti Bakshi

Posted

Yes, agree with poroma with sebaceous differentiation.
I guess the main differential for argument's sake, would be sebaceoma. But the tumour shows multifocal attachment to the surface and the cells are 'poroid' rather than germinative basaloid.
Great case!

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Dr. Mona Abdel-Halim

Posted

Contributing late !!! Poroma with sebaceous differentiation. Lovely case... As Arti said, a sebaceoma would have shown more basaloid nature..

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Mark A. Hurt MD

Posted

I think this has been termed sebocrine adenoma in the past. It looks like an apocrine poroma (acrospiroma) with collections of sebocytes.

Zaim MT. Sebocrine adenoma. An adnexal adenoma with sebaceous and apocrine poroma-like differentiation. Am J Dermatopathol. 1988 Aug;10(4):311-8. PubMed. PMID: 2843062.

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Dr. Richard Carr

Posted

Thanks for all the excellent comments. I reported this as a hybrid poroma / poroid hidradenoma with prominent sebaceous differentiation - this is the first case of this type I have seen (although I might have missed or ignored focal sebaceous previously). Kazakov's book does distinguish poroid hidradenoma (mainly poroid and cuticular squamoid cells +/- clear cells, +/- sebaceous or follicular differentiation, +/- pigmented) from from hidradenoma (range of eosinophilic, squamoid, oncocytic, clear, mucinous and transitional cells but sebaceous not mentioned). I did mention the differential including sebaceoma in the report and commented that Muir Torre was unlikely (but by mentioning the eponym giving the chance for the clinician to think about it). Thanks also to Mark for the reference.

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