Acta Dermato-Venereologica 98-8CompleteContent | Page 30

817 A Subcutaneous Tumour on the Posterior Neck: A Quiz Jun OMATSU, Ryosuke SAIGUSA*, Takuya MIYAGAWA, Hiroko NUMAJIRI, Kaname AKAMATA, Yuri MASUI, Daisuke YAMADA and Shinichi SATO Department of Dermatology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. *E- mail:[email protected] A 51-year-old healthy Japanese man presented with a 1-year history of a subcutaneous asymptomatic tumour, 6×5 cm in size and gradually increasing, on the posterior neck. The patient had undergone cupping therapy on the shoulder and neck for alleviating stiffness once a week for 20 years. On physical examination an elastic, hard, immobile mass with no tenderness or redness was palpable on the posterior neck (Fig. 1A) and a rounded purpura was observed on the shoulder, possibly caused by the cupping therapy. Labora- tory test results including blood count, biochemistry and coagulation were within normal limits. Magnetic resonance imaging (MRI) showed a well-circumscribed, rounded solid mass, with homogeneous intermediate signal intensity (iso- intense to muscle) on T1-weighted images (T1-WI) (Fig. 1B) and inhomogeneous mild high signal intensity involving sporadic scattered low signal intensity areas inside on T2- weighted images (T2-WI) (Fig. 1C) and short T1 inversion recovery (STIR) (Fig. 1D). What is your diagnosis? See next page for answer. Fig. 1. (A) A 6×5 cm asymptomatic subcutaneous tumour on the posterior neck. (B, C, D) Magnetic resonance imaging (MRI) revealed homogenous, intermediate signal intensity on (B) T1-weighted image, and inhomogeneous high signal intensity with scattered low signal intensity areas on (C) T2- weighted and (D) short T1 inversion recovery (STIR). QUIZ SECTION This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2018 Acta Dermato-Venereologica. doi: 10.2340/00015555-2972 Acta Derm Venereol 2018; 98: 817–819