Pearly, pink protuberant tumor on the upper extremity

Presenter: Joseph Del Priore, DO
Dermatology Program: Western University/ Pacific Hospital
Program Director: David C. Horowitz, DO FACD
Submitted on: Jan 21, 2011

CHIEF COMPLAINT:  Bump on arm

CLINICAL HISTORY:

Signs and symptoms:  A 19 year old male presented with a pink, shiny 3 cm protuberant nodule on his right upper extremity that grew rapidly over 2 months.

Previous Treatment:  tea tree oil

Other information:  none

PHYSICAL EXAM:

Solitary 3.2cm well circumscribed, shiny pink nodule on right upper arm that is hard and slightly painful upon palpation. (figure 1)

 

Figure 1

LABORATORY TESTS:

none

DERMATOHISTOPATHOLOGY:

Histopathological examination (see figures 2 and 3) showed sections of nests of cells, some of which presented with a basaloid appearance with regular crowded oval nuclei. There were also associated ghost cells with residual eosinophilic cytoplasm and without preserved nuclei. Scattered chronic inflammatory cells along with multinucleated giant cells and a focus of calcification was present. No evidence of malignancy was identified.

 

Figure 2

 

Figure 3

DIFFERENTIAL DIAGNOSIS:

1.   Dermatofibrosarcoma protuberans
2.   Pilomatricoma / pilomatrical carcinoma
3.   melanoma
4.   SCC
5.   BCC


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