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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 1797 - 18 April - Dr Uma Sundram 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 year old male with 9 mm right inferior lip lesion.

Case Posted by Dr Uma Sundram


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vincenzo polizzi

Posted

It seems like a hybrid myxoid nerve sheath tumor and cellular neurothekeoma...

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Raul Perret

Posted (edited)

Due to the clinical description I would consider in my differential an irritation fibroma (a bit more cellular than routine cases). However, a small ihc panel should be performed (cd34, s-100) to confirm the diagnosis.

Edited by Raul Perret

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vincenzo polizzi

Posted

Yes Raul, I think you hit the nail on head. Due to the abundant myxoid background and the cellularity I didn't think of it.

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Dr. Mona Abdel-Halim

Posted

Agree with irritation fibroma

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Sasi Attili

Posted

Never heard of an irritation fibroma. But the histo is in the the cellular fibroma family...

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Dr. Richard Carr

Posted

Nice to hear of new or old things! Despite the lack of an adipocyte I could not get spindle cell lipoma out of my head on this case.

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Uma Sundram

Posted

Great discussion! The lesion is factor XIIIA strongly positive, and is somewhat cellular for an oral fibroma. We suggested the possibility of an intraoral dermatofibroma to the clinician and he thought that was a good clinical fit. S100 and CD34 are both negative. Cellular neurothekeoma is another good thought. NKIC3 can be positive in both DF and cellular neurothekeoma; somewhat unusual location for both lesions.

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