How would you manage this suspected cyst on the back?

In this week's case discussion, we revisit a submission from Dr Heather Lawson, in which a 64-year-old man presents for the first time, having been sent by his GP for removal of a cyst on his back.

The patient has a personal history of BCC ten years ago, and his father had melanoma. The cyst has been growing over the past six months. Upon examination, Dr Lawson considers it is more solid than cystic.

What are your thoughts on the potential diagnosis?

Update

Here is the pathology report and an additional comment from Dr Heather Lawson:

"I really thought this was a melanoma. I have seen a 2cm thick spindle cell melanoma before that looked like a cyst to two of the patient's GPs, resulting in a five-month delay in excision. I have researched that dermatofibromas can be up to 15mm wide, but I have never seen one like this before. I did ask the pathologist to recheck, and the diagnosis was the same."

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