Case Number : Case 1796 - 17 April - Dr Limin Yu Posted By: Guest

After eating all your Easter eggs I am sure you all have a sugar rush to help you with today's case from Dr Limin Yu.

Don't forget to check out and Like our Facebook page https://www.facebook.com/DermPathPro/ plus follow our Twitter feed https://twitter.com/DermPathPro

COMING SOON... The New York Dermatopathology Review Course 

Geoff Cross - DermpathPRO Projects

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.

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

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.

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

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

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

Sebaceoma.

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

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! 

Dear Limin, CD10, CK20, BerEP4 and EMA?

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

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