Well circumscribed pedunculated friable nodule on the scalp

Presenter: Leeor Porges DO, Khasha Touloei DO, Alexis Stephens DO, Lise Brown DO, Jacqueline Thomas DO, Tracy Favreau DO
Dermatology Program: Broward General Medical Center
Program Director: Tracy Favreau DO
Submitted on: Oct 4, 2013

CHIEF COMPLAINT:  A 25 year old female presented with a 2 month history of a 2.4cm well circumscribed pedunculated friable nodule on her scalp.

CLINICAL HISTORY:

Signs and symptoms:  A 25 year old female presented with a 2 month history of a 2.4cm well circumscribed pedunculated friable nodule on her scalp. The patient had no previous medical history. The patient denied pruritus or pain from the lesion. Clinically the lesion resembled a pyogenic granuloma. A biopsy was performed which revealed alternating nests of adipose and myxoid elements with multiple dilated vascular structures.

Previous Treatment:

Other information:

PHYSICAL EXAM:

Clinically the lesion resembled a pyogenic granuloma.

Clinical image

LABORATORY TESTS:

Shave Biopsy

DERMATOHISTOPATHOLOGY:

A biopsy was performed which revealed alternating nests of adipose and myxoid elements with multiple dilated vascular structures.

DIFFERENTIAL DIAGNOSIS:

1.   Angiolipoma
2.   Pyogenic Granuloma
3.   Myxolipoma
4.   Myxoid spindle cell lipoma
5.   Low grade myxofibrosarcoma


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