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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 2286 - 19 March 2019 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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65 year old woman with lesion on right lower lid


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Nodular growth with rounded but definetely infiltrative margins, made up of atypical sebocytes in different stages of maturation----->>sebaceous carcinoma.

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Krishnakumar subramanian

Posted

nodular Sebaceous gland carcinoma, however cystic spaces with eosinophilic fluid I have not seen in SGC, 

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Meenakshi Batrani

Posted

I will go with Sebaceous carcinoma

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Dr. Mona Abdel-Halim

Posted

Or sebaceoma? Muir Torre syndrome?

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Dr. Richard Carr

Posted

Looks like a small sebaceous adenoma (rather then obvious carcinoma). It's clearly in situ in either case. I'd run p53 for interest. MTS unlikely with solitary sebaceous lesion at this site.

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There is a stromal desmplasia in fig2 and fig3, around the pseudo-circumscribed margin, so I think this a clue to neoplastic invasion of muscle layer.

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John Zhang

Posted

Difficult lesion to classify. To me it is a sebaceoma or a sebaceous adenoma (depends on whether you think the basaloid cells are >50% or not) because of the lack of infiltrative growth pattern. To me the degree of cytologic atypia is definitely there but not severe.

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Uma Sundram

Posted

This is a difficult case, as evidenced by the numerous comments with varying opinions. We did not pull the trigger on carcinoma but were concerned about the lesion (sebaceous neoplasm with atypical features). It was completely excised. All MSI proteins were retained.

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Uma Sundram

Posted

Thank you again, colleagues, for your wonderful and thoughtful comments.

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