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45-Year-Old Woman with Subcutaneous Nodule

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

A 45-year-old female presented with a painful nodule on her finger that has been slowly growing over the last several months. There is no history of trauma or foreign body.

What could be causing this tender subcutaneous nodule?

Choose one to reveal diagnosis and discussion

Angiolipoma
Neuroma
Glomus tumor
Eccrine spiradenoma
Leiomyoma
All of the above

Answer: Neuroma

See the full case at Consultant360

ANGELs (angiolipoma, neuroma, glomus tumor, eccrine spiradenoma, and leiomyoma) are all subcutaneous or dermal benign tumors characterized by pain upon compression. Angiolipomas are usually on the trunk and proximal extremities and appear like a lipoma. Glomus tumors can be seen on the digit, but have a purplish hue similar to the eccrine spiradenoma. Leiomyomas arise from pili erector muscle, which is absent on the fingertip.

This histologic variant was a neuroma, which is very uncommon but can be removed by excision.