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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 1969 - 15 Dec 2017 Posted By: Dr. Richard Carr

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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RAC7795

Clinical Details

F60. Lesion 4th/5th Web space.

Credit: Dr Taibjee

Edited by Admin_Dermpath


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Superficial acral fibromyxoma. Differential diagnosis will include cutaneous myxoma as a component of Carney complex and focal mucinosis

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Raul Perret

Posted

The isn't a prominent vascular component and the architecture is lobular for me this is nerve sheath myxoma

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Iskander H. Chaudhry

Posted

Yes I agree with nerve sheath myxoma - multinodular - with fibrous septae and myxoid bland spindle cells :) 

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vincenzo polizzi

Posted

Like to make a NSM diagnosis at a glance, too. But the cells are chondromatous...In NSM chondroitin sulfate 4 or 6 are the predominant stromal component, but sincerely truly chondrocytes are very unusual. So...what about a myxoid extaskeletal chondroma? 

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Dr. Richard Carr

Posted

I'm waiting for some IHC to be posted.

 

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Dr. Mona Abdel-Halim

Posted

Nerve sheath myxoma is my first thought

 

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Dr. Richard Carr

Posted

Okay S100 was negative and EMA failed to show perinerium. This is a soft tissue myxoma.  Nice mimic of dermal nerve sheath myxomas posted recently.

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John Zhang

Posted

Thanks Dr. Carr for the photos.  Looking at the photos, to me S100 seems to be positive?? My wild guess is that its either nerve sheath myxoma, or, as Vincenzo said, myxoid chondroma since those S100 positive cells are not spindle shaped or stellate. This is too hard...

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