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July 1990

A Solitary Nodule on the Chest

Author Affiliations

USA; USA; USA; Walter Reed Army Medical Center, Washington, DC (Drs Scherbenske, Turiansky, and Sau), and Mount Sinai School of Medicine, New York, NY (Ms Kopeloff)

Arch Dermatol. 1990;126(7):958a-958b. doi:10.1001/archderm.1990.01670310121022

REPORT OF A CASE  A 60-year-old man presented for evaluation of a skin lesion on his chest. The lesion was asymptomatic and was of unknown duration.Physical examination revealed a single, nontender, flesh-colored nodule above the right nipple (Fig 1).A shave biopsy was performed and a representative section is shown in Fig 2.

HISTOPATHOLOGIC FINDINGS  The biopsy specimen contained long, thin, branching, anastomosing, epithelial strands embedded in a fibrous stroma. Small buds were seen projecting from the epithelial strands, with many of the strands showing connections to the surface epidermis.What is your diagnosis?

DIAGNOSIS:  Fibroepithelioma of Pinkus.

DISCUSSION  Fibroepithelioma of Pinkus is thought to be a variant of basal cell carcinoma. Pinkus1 identified this entity in 1953 when he described a "peculiar fibroepithelial tumor" occurring in 4 of 900 cases of basal cell carcinoma. He stressed that these tumors did "not constitute a new entity," but rather "an unusual variety of

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