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April 1991

A Solitary Pigmented Tumor of the Face

Author Affiliations

Lackland Air Force Base, Tex

Arch Dermatol. 1991;127(4):571-576. doi:10.1001/archderm.1991.04510010141020

REPORT OF A CASE  A 57-year-old white man presented to the dermatology clinic because of a gradually enlarging mass on his left cheek that was of cosmetic concern but was otherwise asymptomatic (Fig 1). He had no other pertinent cutaneous lesions. The patient had no history of skin cancer or other significant medical problems.The physical examination was remarkable for a solitary deep purple translucent exophytic 8 × 10-mm nodule on the left cheek. The lesion was smooth and well circumscribed from the surrounding normal skin. Telangiectasias were visible. A shave biopsy specimen was obtained, resulting in collapse of the tumor with yield of a clear, brown-colored fluid. Representative histopathologic sections are shown in Figs 2 and 3.What is your diagnosis?

DIAGNOSIS:  Apocrine hidrocystoma.

DISCUSSION  Histopathologic examination showed an epithelial lining of the cyst composed of columnar cells with a

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