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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 2775 - 24 February 2021 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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82M ,Specimen 1:RT cheek - C&C - 6mmx4mm wart lesion increase in size ?irritated seb keratosis exclude SCC


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Cem Leblebici

Posted

Sebaceous neoplasia

Need excision to rule out malignancy

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Carmen Lisievici

Posted

Sebaceous tumor. I would favor sebaceoma, but full excision is required in order to properly assess the architecture.

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Richard Logan

Posted

I suspect this is a porocarcinoma.

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Alex-Ventura-Leon

Posted

Sebaceoma for me

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vincenzo

Posted

There are too mitosis for a sebaceoma, but favor this diagnosis. 

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Meenakshi Batrani

Posted

I will go with sebaceoma. 

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Victor Delgado

Posted

Sebaceoma

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Iskander H. Chaudhry

Posted

Thank you everyone. Yes, interesting discussion. This is a sebaecous tumour and the question is sebaceoma versus well diff seb carcinoma. I accept porocarcinoma is in the differential but I felt there was definite sebaceous differentiation. You can see increase mitotic activity in a sebaceoma, however, this is typically spare. Stigmata for carcinoma are prominent nucleoli, mitotically activity and pleomorphism - necrosis is a helpful feature. Deep extension, adnexal or lymphovascular invasion are all seen in carcinoma. 

This was reported as favouring an extra-ocular well differentiated sebeacous carcinoma. 

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