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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 2186 - 25 October 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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F10. 22cm mass of the popliteal fossa.


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I see some plump spindle cells embebed in a fibrous stroma without any significant atypia. My first hypothesis is extra-abdominal desmoid fibromatosis. Ihq with beta-catenin can be helpful and be careful this tumor may be familial.

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I agree that desmoid fibromatosis is a good thought. If the biopsy is less collagenous I would consider nodular fasciitis. Need beta-catenin to confirm, and S100 to rule out nerve shealth tumors. I guess we can also try to rule out Low grade fibromyxoid sarcoma by staining for MUC4 but I've never done it.

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Agree with Igor. Fibromatosis is the best spot, because of the above  comments and something much important for me: the overmarked vessels. 

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Raul Perret

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My diagnosis was  desmoid fibromatosis. Morphology is typical: paucicellular spindle cell proliferation lacking atypia + fibrous stroma and thin blood vessels with peripheral edema. I am waiting for the molecular confirmation (muation of exon 3 of the CTNNB1 gene). Syndromic cases tend to be associated with intra abdominal tumors and with colonic polyps Gardner's syndrome. The present setting is more frequently seen in sporadic cases. If CTNNB1 mutation is absent then we could suggest this hypothesis. 

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