[consuldreugenio]

I call it a sebaceous cyst and move on. Or, I dont mention it.

[Unknown Member]

I agree to keep them in perspective, but to be honest, have seen metastatic melanoma look identical.

[JohnnyFever]

Don’t bother calling them. DDX as possibly malignant will do more harm than good. Unless it has suspicious features, let it be

[Unknown Member]

Recommend clinical correlation and MRI with spectroscopy,

[francomejiamurillo_751]

Ignore.  

[cytek1]

Ignore. Its not really our job to raise the possibility of malignancy in something that they can see with their eyes, and something which is almost certainly benign.

[tselvidas_246]

Technically they are not sebaceous cyst; its a misnomer.

[Ajackcash]

Probable sebaceous cyst

[btomba_77]

Rounded lesion in the subcutaneous tissues involving the dermis. The lesion is small and superficial and thus likely to be cystic or non-aggressive.  However, solid neoplasm, while not likely, is also not excluded. Correlate with direct visualization and physical exam findings to determine the need for further evaluation.

[btomba_77]

I live in the world of tertiary/quaternary referral for soft tissue sarcomas.  Once every year or two some lesion like this will be referred in and end up being a DFSP or other sarcoma despite everyone thinking it was a cycst.
 
This certainly colors my thinking on the matter.

[jess6184]

Ignoring these is not an option with my referrers.   I will get a call on about 20% of them telling me I missed a mass.

[leann2001nl]

If you say all that crap about a pimple then the reports in general must be super hedgy

[btomba_77]

If [i]hedgy[/i] you mean to imply “CT can not reliably differentiate benign from malignant superficial soft tissue masses” then yes, that report would be “hedgy”      
 
(I would personally call it clinically appropriate and in the patient’s best interest as well .. but toMAYto toMAHto) 

[cytek1]

Youre going to put that in an impression every time you see a 4 mm skin lesion? Give me a break!

[leann2001nl]

Quote from dergon

If [i]hedgy[/i] you mean to imply “CT can not reliably differentiate benign from malignant superficial soft tissue masses” then yes, that report would be “hedgy”      

(I would personally call it clinically appropriate and in the patient’s best interest as well .. but toMAYto toMAHto) 

 
So do you say that every time someone has a blister too? Could be melanoma 

[stlmchenry_510]

The Incidental Finding Wormhole of Radiology

[stlmchenry_510]

Its always a tough call-not wanting to overlook or downplay an early cancer or something important as well as covering yourself vs. alarming the patient about something that is most statistically likely benign. I usually downplay sebaceous/pilar/trichelemmal cysts..Knock on wood

[stlmchenry_510]

However, as stated above-a metastatic node can have a similar appearance.

[sehyj1]

I just say normal versus stage 4 mets. But I say that for every study I read

[Unknown Member]

Everyone dies at some point, so Ive really sped up my dictations with Impression: terminal illness.

Clinicians appreciate that I am never wrong.