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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 4069 - 25 August 202 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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90F ?BCC right nostril

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Combined adnexal tumor: left easier: trichoblastoma. Right...thinking of an apocrine benign tumor...?apocrine adenoma. But I don’t see enough papillary changes. 

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Trichoblastoma on the left, apocrine cystadenoma on the right.

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Agree, TB on the left, a benign eccrine/apocrine tumor on the right. Not sure what the best name for it is. The collagenous stroma raises the possibility of a hidradenoma with apocrine differentiation?

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Saleem Taibjee


Yes, well done. I too concluded that this is a combination of trichepithelioma and tubular apocrine adenoma (debatable nomenclature). A rather curious and unique recent case!

A couple of the immunos are shown below (requested more for interest, but not altering the impression on H&E). The CEA nicely highlights the ducts in the glandular component, and the CD10 highlights the papillary mesenchymal cells in the trichoepithelioma.



46409_20.0x CD10 labelled.jpg


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