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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 1796 - 17 April - Dr Limin Yu 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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Clinical History: 64 male, right cheek.

Case Posted by Dr Limin Yu


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Robledo F. Rocha

Posted

Intradermal multilobular tumor composed by basaloid germinative cells, some of them showing enlarged and hyperchromatic nuclei, with admixture of some mature sebocytes. Sebaceoma is my opinon.

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Dr. Mona Abdel-Halim

Posted

Two diagnoses crossed my mind: trichoblastoma with seb differentiation and sebaceoma but I am favoring the first possibility.

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vincenzo polizzi

Posted

I'm sure this is an adnexal low grade/benign tumor with sebaceous differentiation...but when I try to label it I become confused.

Moreover the tumor looks like more a trichoblastoma than a sebaceoma.

I've learned a gold rule in sebaceous neoplastic pathology: " when you see something resembling a sebaceous tumor, but you are having a hard time to define it, think of Muir Torr syndrome"...So I share the Mona's preference, trichoblastoma with sebaceous differentiation, but I would make MSH2, MLH1.

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Agree with above comments. I believe this is a sebaceoma and I would also perform MSI immunostains.

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Raul Perret

Posted

Spot diagnosis sebaceoma. Would still perform immunos including ber-ep4, ema for excluding bcc with sebaceous differentiation although I do not favour this diagnosis based on morphology

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Sasi Attili

Posted

15 hours ago, Dr. Mona Abdel Halim said:

Two diagnoses crossed my mind: trichoblastoma with seb differentiation and sebaceoma but I am favoring the first possibility.

me too

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Dr. Richard Carr

Posted

Sebaceoma.

Comment in reporting such lesions: Solitary lesions on the head of older individuals  are rarely associated with Muir Torre syndrome.

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Limin Yu

Posted

Thank everyone for the excellent discussion. I signed out this case as a trichoblastoma with focal sebaceous differentiation. The point of sebaceoma is well taken! 

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Dr. Richard Carr

Posted

Dear Limin, CD10, CK20, BerEP4 and EMA?

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Limin Yu

Posted

Dr. Carr, I didn't perform immunostains on this case

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Nada Macaron

Posted

Dr. Carr. Can you please comment on how the above mentioned stains would help in the DDX?

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