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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 2678 - 12 October 2020 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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76M, Lesion on scalp. ?BCC ?SCC


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Difficult for me. I would like a spot of Sebaceoma...but there are pleomorphism, mitosis and apoptotic necrosis ( not necrosis en masse ). So agree with Colleagues. Sebaceous Carcinoma, in situ!

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Meenakshi Batrani

Posted

Difficult to distinguish these borderline tumors- sebaceoma and low grade sebaceous carcinoma/sebaceous carcinoma in situ. 

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Admin_Dermpath

Posted

Thank you for your comments.

We went through the same thought process considering Sebaceoma versus carcinoma. However, the borders of the lesion are irregular and there is marked pleomorphism and mitotic activity. The lesion is 3.3 mm thick. There is infiltration of subcutaneous fat. Base on this, a diagnosis of extraocular sebaceous carcinoma was rendered. No comedo-necrosis is seen.

Iskander H. Chaudhry

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Dr. Richard Carr

Posted

I'd favour sebaceoma. Ki67 (peripheral), p16 & p53 which should help. Does not appear invasive either (even if carcinoma), can do EVG. 

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