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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 2224 - 18 December 2018 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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35 year old male with lesion on right cheek. R/o cyst.


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Krishnakumar subramanian

Posted

sinus like tract with inverted mucoepidermoid papilloma

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Sebaceoma-like NEVUS SEBACEUS with apocrine-ductal changes and some abortive SCAP structures. 

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Would like to do IHC - BerEP 4 and EMA to say the least. Looks like a BCC to me. 

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Alex-Ventura-Leon

Posted

Honestly I dont know whats going on here. But I like the idea of Vincenzo. i have never seen a similar case.

Waiting for more learning.

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Krishnakumar subramanian

Posted

Please let us know what is the final diagnosis

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Uma Sundram

Posted

Yes, my apologies, I always want to post the answer on tuesday but have to wait until you all have a chance to comment. Then of course wednesday starts...

It's a really interesting case, isn't it? We finally landed on poroid hidradenoma. The overall architecture is that of a hidradenoma with the cells of a poroma. We recommended a re excision, as BCC is certainly part of the differential. I also like a variant of nevus sebaceus with areas that look like syringocystadenoma papilleferum.

I personally have never seen an inverted mucoepidermoid papilloma outside of the eye, so favored this less.

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