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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 2263 - 14 February 2019 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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8 month infant with polypoid lesion in the upper gums


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HENRY

Posted (edited)

Submucosal vascular lesion with anastomosing lymphatic chanels lined by prominent endothelial cells which are not very atypical, focal intraluminal papillary proliferation is noted. I think it is  benign lymphangioendothelioma(old term APL). multiple lesions can happen with thrombocytopenia which can result severe bleeding. Not kaposi to me.

Edited by HENRY

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I like Henry's comment. No inflammatory infiltrate, no hemosiderin, intraluminal papillary projections and promontory sign are in keeping with Lymphangioendothelioma...but last two pics are reminiscent of Hemangioblastoma.Im not familiar with extracerebellar hemangioblastomas. So this is a puzzle case for me. 

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Lymphangioendothelioma (progressive lymphangioma) is a great thought. Also see case 2244.

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6 hours ago, Alex-Ventura-Leon said:

What about Glial (whit pseudovascular configuration) and meningeal (last two pictures) heterotopia?

I remember a similar case here: Case Number : Case 1564 - 23 June

That is a brilliant idea. I did note those last two images resembling glial tissue.. bravo!

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If in the scalp, it could be a meningothelial hamartoma/choristoma of Suster... In the gum it could be a glial and meningeal heterotopia...But histology is more in keeping with Suster's tumor. I don't know.

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Raul Perret

Posted

I called this extracranial meningioma/meningothelial heteropia. The dissecting/pseudovascular pattern has been more frequently described in meningothelial heteropia but whether this lesions represent hamartomas or true neoplasms is controversial.

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