RESUMO
An 11-year-old boy presented generalized eruptive syringomas (ESs) associated with multiple milia-like whitish palmar papules corresponding to dermal calcium deposits. A relationship between calcium deposits distribution to an underlying eccrine duct was noted on pathology. The observation of dermal calcium deposits and its association with generalized ESs may support a possible sweat duct origin of this uncommon and peculiar form of superficial calcinosis cutis.
Assuntos
Calcinose , Neoplasias das Glândulas Sudoríparas , Siringoma , Humanos , Masculino , Calcinose/patologia , Calcinose/etiologia , Siringoma/patologia , Criança , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/complicações , Dermatopatias/patologia , Dermatopatias/etiologia , Calcinose Cutânea , CeratoseRESUMO
Eccrine syringofibroadenoma (ESFA) is a rare adnexal tumor deriving from the acrosyringeal portion of the eccrine duct. Five subtypes of ESFA were described including a reactive form. Reactive ESFAs are associated with inflammatory and neoplastic dermatoses. In this article, we report the case of a 90-year-old woman presenting with 3 leg ulcers evolving for 2 years surrounded by large verrucous and eczematous lesions. Multiple skin biopsies showed anastomosing epithelial cords connected to the epidermis consistent with ESFA. We identified 8 cases of ESFA associated with chronic leg ulcers in the literature and reviewed their main clinical and histological features.
Assuntos
Adenoma de Glândula Sudorípara , Úlcera da Perna , Neoplasias Cutâneas , Neoplasias das Glândulas Sudoríparas , Úlcera Varicosa , Feminino , Humanos , Idoso de 80 Anos ou mais , Adenoma de Glândula Sudorípara/complicações , Adenoma de Glândula Sudorípara/patologia , Neoplasias das Glândulas Sudoríparas/complicações , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/patologia , Pele/patologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Úlcera Varicosa/patologia , Úlcera da Perna/patologia , Glândulas Écrinas/patologiaRESUMO
A 56-year-old woman with hypohidrotic ectodermal dysplasia presented with a 10-year history of persisting wart-like skin lesions on her feet. Biopsy revealed changes of eccrine syringofibroadenoma. These lesions are rare, with only nine case reports describing an association with ectodermal dysplasia of hidrotic type (Clouston and Schopf's syndrome). To our knowledge, this is the first case of eccrine syringofibroadenoma developing in the hypohidrotic/anhidrotic subtype of ectodermal dysplasia.
Assuntos
Adenoma de Glândula Sudorípara/patologia , Displasia Ectodérmica/complicações , Transtornos de Início Tardio , Neoplasias das Glândulas Sudoríparas/patologia , Adenoma de Glândula Sudorípara/complicações , Displasia Ectodérmica/patologia , Feminino , Humanos , Extremidade Inferior/patologia , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/complicaçõesAssuntos
Epidermólise Bolhosa Distrófica , Epidermólise Bolhosa , Poroma , Neoplasias das Glândulas Sudoríparas , Epidermólise Bolhosa/genética , Epidermólise Bolhosa Distrófica/complicações , Epidermólise Bolhosa Distrófica/genética , Genes Recessivos , Humanos , Pele , Neoplasias das Glândulas Sudoríparas/complicações , Neoplasias das Glândulas Sudoríparas/diagnósticoRESUMO
We describe a rare case of an eccrine syringofibroadenoma with a foci of squamous cell carcinoma in situ, which has to best of our knowledge been reported only twice in the English literature. An excisional biopsy of an elevated, lobular tumor of the lower leg in an 86-year-old male patient was performed. Histologic examination revealed a tumor consisting of anastomosing strands of epithelial cells originating from the epidermis, occasionally showing ductal eccrine differentiation. Foci of squamous cell carcinoma in situ were observed within the described lesion. The diagnosis of eccrine syringofibroadenoma with squamous cell carcinoma in situ was established. Eccrine syringofibroadenoma is a rare lesion, mostly considered to be a reactive process arising secondarily in association with other cutaneous diseases such as dermatoses or neoplasms, although some researchers do not exclude the possibility that it is a primary neoplasm with a potential for malignant transformation.
Assuntos
Carcinoma de Células Escamosas , Fibroadenoma , Poroma , Neoplasias das Glândulas Sudoríparas , Masculino , Humanos , Idoso de 80 Anos ou mais , Neoplasias das Glândulas Sudoríparas/complicações , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/patologia , Poroma/patologia , Fibroadenoma/diagnóstico , Fibroadenoma/patologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Células Epiteliais/patologia , Glândulas Écrinas/patologiaRESUMO
Eccrine mucinous nevus is an uncommon hamartoma whose histological diagnosis is simple because of its peculiar morphological features, which include an increase in the number and/or size of the glands and eccrine ducts accompanied by abundant mucin deposits. When it presents with the typical symptom, focal hyperhidrosis, clinical suspicion is possible. El nevus mucinoso ecrino (NME) es un hamartoma escasamente reportado en la literatura cuyo diagnóstico histológico es sencillo debido a sus peculiares rasgos morfológicos, que incluye un aumento del número y/o tamaño de las glándulas ductos ecrinos acompañado de abundante depósito de mucina. Cuando presenta los hallazgos típicos, como la hiperhidrosis focal, es posible su sospecha clínica.
Assuntos
Nevo/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Humanos , Hiperidrose/etiologia , Masculino , Pessoa de Meia-Idade , Nevo/complicações , Neoplasias das Glândulas Sudoríparas/complicaçõesRESUMO
Apocrine hidrocystoma is a benign, cystic lesion often presenting in the periorbital region. Apocrine adenocarcinoma is the rare, malignant counterpart occurring mainly in the axilla and anogenital region. There is a paucity of literature on both entities and co-occurrence has been reported in only 5 cases. We present the case of a 48-year-old man with a history of total body irradiation for chronic myelocytic leukemia, diabetes mellitus, and obesity who presented with a calf mass of two years' duration. Epidermal inclusion cyst was presumed and excisional biopsy was carried out. Pathologic analysis revealed apocrine adenocarcinoma in the setting of a precursor apocrine hidrocystoma. Our patient's unique altered immunity and the direct effects of irradiation on the local microenvironment may have resulted in his rare presentation of co-occurrence of apocrine adenocarcinoma within an existing apocrine hidrocystoma. To our knowledge, our patient is the first reported patient with this presentation in the lower extremity.
Assuntos
Adenocarcinoma/patologia , Hidrocistoma/patologia , Perna (Membro) , Neoplasias das Glândulas Sudoríparas/patologia , Adenocarcinoma/complicações , Hidrocistoma/complicações , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/radioterapia , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/complicações , Irradiação Corporal TotalAssuntos
Lúpus Eritematoso Sistêmico/complicações , Neoplasias Primárias Múltiplas/complicações , Poroma/complicações , Neoplasias das Glândulas Sudoríparas/complicações , Glândulas Écrinas , Humanos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/patologia , Poroma/patologia , Neoplasias das Glândulas Sudoríparas/patologiaRESUMO
Porocarcinoma (PC) is a malignant neoplasm arising from the intraepidermal ductal portion of the sweat gland duct. Lichen planopilaris (LPP) is a not so rare variant of cutaneous lichen planus (LP) with a preferential involvement of hair follicles, consisting of a chronic lymphocytic inflammation, leading to cicatricial alopecia. A 42-year-old woman, recently diagnosed with HIV infection, was referred to our clinic because of an alopecic patch of 6 years' duration. In the upper region of the alopecia a 1.5cm nodule was noticed, which the patient stated had started growing soon after the appearance of the hair loss. Biopsy of the alopecia margin confirmed the diagnosis of LPP, whereas biopsy of the nodule revealed an infiltrating tumor consistent with the diagnosis of PC. We present a scalp PC emerging in a background of LPP in an HIV patient. We do not know the role, if any, HIV infection and LPP played in this particular case. Immunosuppression and HIV have been implicated in the etiology of PC. However, her HIV diagnosis was made after the appearance of the scalp nodule. We did not find any association between LPP and PC in the literature. Even though an association by chance cannot be excluded, this deserves further investigation.
Assuntos
Porocarcinoma Écrino/complicações , Neoplasias de Cabeça e Pescoço/complicações , Líquen Plano/complicações , Dermatoses do Couro Cabeludo/complicações , Couro Cabeludo , Neoplasias das Glândulas Sudoríparas/complicações , Adulto , Feminino , Infecções por HIV/complicações , Folículo Piloso , HumanosAssuntos
Neoplasias Primárias Múltiplas/diagnóstico , Nevo/diagnóstico , Poroceratose/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Adulto , Braço , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/patologia , Nevo/complicações , Nevo/patologia , Poroceratose/complicações , Poroceratose/patologia , Neoplasias das Glândulas Sudoríparas/complicações , Neoplasias das Glândulas Sudoríparas/patologiaRESUMO
Primary cutaneous cribriform apocrine carcinoma is a rare but distinct variant of primary cutaneous apocrine carcinoma and it is considered a low grade malignancy. We herein present a case of primary cutaneous cribriform apocrine carcinoma at the neck of a 26-year-old female. The tumor features a relatively well-circumscribed border and multiple aggregations of mildly pleomorphic epithelial cells with large ovoid nuclei, small nucleoli and abundant eosinophilic cytoplasms. Cribriform and tubular structures are the major architectural patterns. The primary differential diagnosis is cutaneous metastasis from a cribriform visceral carcinoma; others include primary secretory carcinoma of the skin, adenoid cystic basal cell carcinoma and primary cutaneous adenoid cystic carcinoma.
Assuntos
Adenocarcinoma/diagnóstico , Glândulas Apócrinas/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Adenocarcinoma/complicações , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias das Glândulas Sudoríparas/complicaçõesAssuntos
Adenoma de Glândula Sudorípara/diagnóstico , Adenoma/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Adenomas Tubulares de Glândulas Sudoríparas/diagnóstico , Adenoma/complicações , Adenoma de Glândula Sudorípara/complicações , Adolescente , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias das Glândulas Sudoríparas/complicações , Adenomas Tubulares de Glândulas Sudoríparas/complicaçõesRESUMO
An upper lid eccrine hidrocystoma presenting as early childhood progressive ptosis is very rare. We present a 9-year-old female child with droopy right upper lid since birth and progressive increase in symptoms. She had right upper lid ptosis (marginal reflex distance 1 of -1 mm) with fair levator function (8 mm) and abnormal cystic change on the conjunctival side. Computerized tomography imaging delineated the well-defined cystic lesion with homogeneous cavity with no contrast enhancement. Following the cyst excision, a giant eccrine hidrocystoma measuring 25 mm × 15 mm was removed, the largest reported in pediatric eyes. The case demonstrates the possibility of giant lid eccrine hidrocystomas presenting as progressive ptosis at a pediatric age and the need for early surgical intervention to prevent amblyopia.
Assuntos
Blefaroptose/etiologia , Neoplasias Palpebrais/complicações , Pálpebras/patologia , Hidrocistoma/complicações , Estadiamento de Neoplasias , Neoplasias das Glândulas Sudoríparas/complicações , Blefaroptose/diagnóstico , Blefaroptose/cirurgia , Criança , Diagnóstico Diferencial , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/cirurgia , Pálpebras/cirurgia , Feminino , Hidrocistoma/diagnóstico , Hidrocistoma/cirurgia , Humanos , Procedimentos Cirúrgicos Oftalmológicos/métodos , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgiaAssuntos
Amiloidose/complicações , Pele/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Adenomas Tubulares de Glândulas Sudoríparas/diagnóstico , Amiloidose/diagnóstico , Dorso , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/complicações , Adenomas Tubulares de Glândulas Sudoríparas/complicaçõesRESUMO
A 75-year-old man with human immunodeficiency virus infection and numerous biopsy-proven warts for 10 years, refractory to cryosurgery, cimetidine, and topical imiquimod, presented with numerous pink to hypopigmented verrucous papules and plaques involving the face, trunk, buttocks, and groin. Laboratory evaluation revealed a CD4 T-cell count of 62 cells per microliter and human immunodeficiency virus viral load of <117 copies per milliliter. Biopsy of a plaque groin lesion was performed. Histopathology revealed vertically oriented anastomosing strands of basaloid epithelium arising from multiple points along the epidermis in a background fibrovascular stroma. Ductal differentiation was identified. Areas of epidermis showed compact orthokeratosis, coarse hypergranulosis, and keratinocytes with abundant steel-blue-gray cytoplasm, indicative of viral cytopathic changes. Cytologic atypia was not identified. Human papillomavirus (HPV) genotyping of this lesion was positive for types 5 and 14. Overall, the findings were consistent with epidermodysplasia verruciformis in association with eccrine syringofibroadenoma (ESFA). The patient was subsequently treated with acitretin and showed clinical improvement. ESFA is an uncommon benign adnexal tumor with unknown pathogenesis. Although its association with HPV has rarely been reported, ESFA in the setting of acquired epidermodysplasia verruciformis has not been described. The development of ESFA in this case may be the result of HPV-induced cellular transformation.
Assuntos
Epidermodisplasia Verruciforme/complicações , Infecções por HIV/complicações , Infecções por Papillomavirus/complicações , Poroma/complicações , Neoplasias das Glândulas Sudoríparas/complicações , Idoso , Transformação Celular Viral , Epidermodisplasia Verruciforme/patologia , Epidermodisplasia Verruciforme/virologia , Humanos , Masculino , Poroma/patologia , Poroma/virologia , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/virologiaAssuntos
Fibroadenoma/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Fibroadenoma/complicações , Fibroadenoma/diagnóstico , Hepatite B Crônica/complicações , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias das Glândulas Sudoríparas/complicações , Neoplasias das Glândulas Sudoríparas/diagnósticoRESUMO
The purpose of this study was to determine (a) the frequency of apocrine metaplasia (ApoM) found on MR core biopsy of suspicious findings, and (b) to determine if there are specific MR imaging features that might obviate the need for biopsy. This HIPAA-compliant retrospective study was performed under IRB exemption for quality assurance studies. Patient demographics, MR imaging features, and pathology were reviewed. Breast lesions which underwent MR-guided biopsy, yielding ApoM on pathology analysis were included. Retrospective review of MR imaging features of these lesions was performed by two radiologists blinded to pathology results except for the presence of ApoM. Imaging features on MR assessed included location, size, morphology, T1 and T2 signals, and enhancement kinetics. Full pathology results were subsequently reviewed during data analysis. The pathology slides and imaging was subsequently reviewed by two fellowship trained radiologists and a breast pathologist to categorize the finding of ApoM into target lesion (imaging corresponds to size of lesion on pathology) versus incidental lesion. Target lesion characteristics were assessed to determine specific MRI features of ApoM. Between January 2011 to November 2012, 155 distinct breast lesions suspicious for malignancy successfully underwent MR-guided biopsy. Of the 155 lesions biopsied, 123 (79%) were benign and 32 (21%) were malignant. Of the 123 benign biopsies, ApoM was found in 57 (46%), of which 35 (61%) had no associated atypia and 22 (39%) had associated atypia. Of the 32 malignant biopsies, three (9%) had associated ApoM (DCIS in two cases and DCIS/LCIS in one case). Of the 60 cases with ApoM, only 11 (18.3%) were target lesions and 49 were incidental lesions (81.7%). Of the 60 cases with ApoM, 35 (58%) were masses (average size 0.8 cm for both with or without atypia) and 25 (42%) were nonmass enhancement (NME) (average size 2.1 cm with and 1.0 cm without atypia). Only five (14%) of 35 masses demonstrated spiculated margins, of which four were associated with atypia (80%). Of 22 lesions with atypia or other high-risk lesion, 14 (64%) were masses, most commonly with irregular margins (64%). Of the 12 T2 hyperintense lesions, only two (1.7)% had associated atypia or high-risk lesion, and none were associated with malignancy. Of the 11 target lesions, seven were T2 hyperintense. Enhancement kinetics were variable: 30 (50%) showed mixed persistent and plateau kinetics, eight (13%) persistent delayed enhancement, 10 (17%) plateau kinetics, four (7%) washout kinetics, and eight (13%) were below threshold for kinetic analysis. ApoM is a common benign pathologic result at MR-guided core biopsy for both masses and NME accounting for 39% of all biopsy results in this series. Although there is considerable variability in imaging characteristics on MR, our results suggest biopsy may be safely obviated for lesions that are subcentimeter T2 hyperintense areas of NME and short term follow-up imaging may be a reasonable alternative for these lesions.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem , Adulto , Idoso , Glândulas Apócrinas/patologia , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Feminino , Humanos , Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/complicações , Neoplasias das Glândulas Sudoríparas/patologiaRESUMO
Hidradenomas are tumours that arise from the adnexal structures, both eccrine and apocrine and are histologically benign. The tumours that arise from eccrine differentiation are known as poroid hidradenomas and when they arise from the apocrine glands they are called nodular hidradenomas. In our centre a 13-year-old boy presented with a slow-growing, painless erythematous fungating nodule on the left upper arm over a period of 18 months at the site of the BCG vaccination. The nodule was surgically excised and sent for histopathological examination, leading to a diagnosis of nodular hidradenoma. This case is presented to highlight its rarity, together with its clinical features that were suggestive of malignancy but proved ultimately to be benign.