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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 2216 - 6 December 2018 Posted By: Raul Perret

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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59 y old female with 20 mm a superficial tumor located at the flank.


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Differential for me low cellular ossifying fibromyxoid tumor 1st

myxoid neurofibroma

myoepithelioma

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MUC4? Thinking of a LGFMS, with eterotopic focal ossification.

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I'd like to see S100. If positive I would consider neurothekeoma. If negative maybe LGFMS. Not too sure.

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Alex-Ventura-Leon

Posted

Agree whit Vincenzo. My first possibility would be a LGFMS. Although it seems to small (20mm) and "superficial" for this entity.

Really interesting.

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Raul Perret

Posted

Yes, this was a case of low grade fibromyxoid sarcoma with osseous metaplasia, a rare finding in this tumor. Ossifying fibromyxoid tumor is in the differential and it can also express MUC4 (although rarely), the tigroid pattern and the higher degree of atypia are the main points that help  make things apart in the present case. RT-PCR showed a FUS-CREB3L2 fusion which is quite specific for LGFMS. Have a great weekend. 

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drkhaledhindi

Posted

Raul your cases are super cool and high yield.

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Raul Perret

Posted

Happy that they are useful. Thanks for the good vibes

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