Cases of Interest

A 49-year-old male had an injury 2 decades ago and recently developed nodular swelling of the distal index finger (Fig. 1). Procedure: Left index finger debridement. The resultant pink-tan 17 x 14 x 11-mm specimen was mottled by white chalky deposits. Microscopically, multinucleated giant cells contained pale yellow-green translucent material that was weakly birefringent (Fig. 2). Mononuclear histiocytes contained finely particulate material that appeared jet black under conventional transillumination (Fig 3).

Your diagnosis is:

  • Gout
  • Calcium pyrophosphate deposition disease
  • Paint
  • Pigmented giant cell tumor of tendon sheath
  • Metastatic melanoma

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An otherwise healthy 33-year-old woman gave a 6-week history of a left superolateral orbital mild tenderness, ptosis, proptosis, and diplopia on upgaze. MRI shows a superolateral orbital mass (Figs. 1 & 2). A biopsy was performed (Fig. 3).

This is:

  • Spiradenoma
  • Spiradenocarcinoma
  • Spiradenocylindrocarcinoma
  • Adenoid cystic carcinoma of the lacrimal gland
  • Eccrine carcinoma
  • Glandular schwannoma
  • Metastatic carcinoma

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