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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 1983 - 10 Jan 2018 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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45 F, Right lower leg excision. ?Dysplastic naevus. To exclude melanoma.

Edited by Admin_Dermpath


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Arif Usmani

Posted

Superficial atypical Spitz tumor vs spitzoid melanoma arising within superficial atypical Spitz tumor

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vincenzo polizzi

Posted

No maturation. Expansive growth of the dermal nests...this is a melanoma!

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Dr. Hafeez Diwan

Posted

I would stain it (HMB45 and Ki67) and FISH it. 

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My guess is there would be not a lot of agreement unless doing what Dr. Diwan suggested. But I would not really feel comfortable calling it benign. 

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Dr. Richard Carr

Posted

Difficult! Atypical compound Spitz tumour of low risk. Agree that FISH, CGH etc. may be helpful but I would not call this melanoma without additional criteria (that I don't see here) including asymmetry, pagetoid spread laterally, significant dermal mitotic activity at all levels and lack of different clones. It looks out. Watchful waiting only for me.

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Uma Sundram

Posted

I'm concerned about melanoma too, but am not willing to pull the trigger yet. I am not a big 'stain' or special studies person... So if it's not out, probably ask for a re excision and watch over time. 

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Admin_Dermpath

Posted

Hi Everybody,

 

Doctor Chaudhry's final diagnosis was STUMP, a Spitzoid Tumour of unknown malignant potential, the main reason for this was, despite the nuclear pleomorphism, mitotic activity was virtually absent.

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