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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 2840- 26 May 2021 Posted By: Dr. Hafeez Diwan

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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62 year-old male with left shin lesion.


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Richard Logan

Posted

A spindle cell tumour apparently arising in the dermis.  Cells are arranged in fascicles and show nuclear pleomorphism, atypical mitotic activity and a mucinous stroma.

I am thinking along the lines of low-grade fibromyxosarcoma, a myxoid variant of DFSP (less likely) or myxofibrosarcoma (but no curvilinear blood vessels visible).

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Krishnakumar subramanian

Posted

plexiform spindle cell tumor with atypia

Minimal IHC markers needed

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daniellindsay

Posted (edited)

Spindle cell tumour with atypia and mitotic activity. I would consider smooth muscle differentiation on the basis of morphology, likely leiomyosarcoma. Agree IHC needed. Clinical/radiological correlation needed to ascertain if this is primary or metastatic. 

Edited by daniellindsay

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Richard Logan

Posted

I think the sharply demarcated bundles suggest a primary rather than secondary tumour, but I may be wrong.

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vincenzo

Posted

Leiomyosarcoma/atypical dermal smooth muscle tumor. 

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Eman El-Nabarawy

Posted

Atypical dermal smooth muscle tumor.

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Dr. Hafeez Diwan

Posted

Leiomyosarcoma (desmin positive)

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