RESUMO
ABSTRACT: Eccrine angiomatous hamartoma (EAH) is a rare hamartoma characterized by a benign proliferation of eccrine glands and vascular structures in the dermis. These tumors rarely regress spontaneously, so surgical excision of the involved tissue is required when pain or enlargement occurs. Here, the authors report the clinical case of a patient affected by an extremely painful EAH with the atypical localization at the last phalanx of the thumb of the right hand with involvement of nail matrix and nail bed. This report aims to emphasize the application of Mohs micrographic surgery for the treatment of painful EAH in a very difficult area at potential risk of amputation while preserving the maximum anatomical integrity and function of the damaged area. These results can pave the way for the use of Mohs micrographic surgery for very carefully selected benign neoplasms when their surgical removal is required.
Assuntos
Hamartoma , Doenças das Glândulas Sudoríparas , Humanos , Cirurgia de Mohs , Doenças das Glândulas Sudoríparas/diagnóstico , Doenças das Glândulas Sudoríparas/cirurgia , Doenças das Glândulas Sudoríparas/patologia , Glândulas Écrinas/patologia , Glândulas Écrinas/cirurgia , Hamartoma/complicações , Hamartoma/cirurgia , Hamartoma/patologia , Mãos , DorRESUMO
We describe a simple and efficient method to isolate eccrine sweat glands from the human scalp. This method is inspired by the hair graft harvesting method used in hair transplantation. Based on the recently described anatomical relationship between the scalp hair follicle and the eccrine gland, we have found that scalp follicular unit grafts are an excellent eccrine gland isolation source, especially for the coiled component. In order to make the gland visible for stereoscopic microdissection, the follicular units need to be previously stained with a vital dye like methylene blue or neutral red. The simplicity and efficiency of this isolation method should encourage further research into human eccrine sweat gland function which has always been hindered by the difficulty of gland isolation.
Assuntos
Corantes , Glândulas Écrinas/cirurgia , Couro Cabeludo , Coloração e Rotulagem/métodos , Glândulas Écrinas/anatomia & histologia , Folículo Piloso/anatomia & histologia , Humanos , Azul de Metileno , Microdissecção , Vermelho Neutro , Couro Cabeludo/anatomia & histologia , Coleta de Tecidos e Órgãos/métodosAssuntos
Glândulas Écrinas/patologia , Melanoma/patologia , Cirurgia de Mohs , Neoplasias Cutâneas/patologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Glândulas Écrinas/cirurgia , Feminino , Seguimentos , Humanos , Antígeno MART-1/análise , Masculino , Melanoma/diagnóstico , Melanoma/cirurgia , Invasividade Neoplásica/diagnóstico , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoAssuntos
Carcinoma Ductal/terapia , Carcinoma de Apêndice Cutâneo/terapia , Cirurgia de Mohs/estatística & dados numéricos , Recidiva Local de Neoplasia/epidemiologia , Neoplasias das Glândulas Sudoríparas/terapia , Idoso , Idoso de 80 Anos ou mais , Biópsia , Carcinoma Ductal/diagnóstico , Carcinoma Ductal/patologia , Carcinoma de Apêndice Cutâneo/diagnóstico , Carcinoma de Apêndice Cutâneo/patologia , Glândulas Écrinas/patologia , Glândulas Écrinas/efeitos da radiação , Glândulas Écrinas/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Radioterapia Adjuvante/estatística & dados numéricos , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/patologia , Resultado do Tratamento , Carga TumoralRESUMO
Eccrine nevus shows increase in number or size of eccrine glands, whereas hair follicle nevus is composed of densely packed normal vellus hairs, and eccrine-pilar angiomatous nevus reveals increase of eccrine, pilar, and angiomatous structures. No case with increased number of both eccrine glands and hair follicles only in the dermis has been previously reported. A 10-month-old girl presented with cutaneous hamartoma with overlying skin hyperpigmentation on her left hypochondrium since 3 months of age, in whom the lesion was completely excised. Histopathology demonstrated evidently increased number of both eccrine glands and hair follicles in the dermis with reactive hyperplasia of collagen fibers. No recurrence occurred after the tumor was completely excised. A term "hybrid eccrine gland and hair follicle hamartoma" is proposed for this unique lesion.
Assuntos
Glândulas Écrinas/patologia , Folículo Piloso/patologia , Hamartoma/patologia , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Biópsia , Glândulas Écrinas/cirurgia , Feminino , Folículo Piloso/cirurgia , Hamartoma/classificação , Hamartoma/cirurgia , Humanos , Lactente , Neoplasias de Anexos e de Apêndices Cutâneos/classificação , Neoplasias de Anexos e de Apêndices Cutâneos/cirurgia , Nevo/classificação , Nevo/cirurgia , Valor Preditivo dos Testes , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/cirurgia , Terminologia como AssuntoRESUMO
Cutaneous ciliated cysts (CCC) are rare benign cysts known to occur in the lower extremities of females of reproductive age. Currently, there are 2 theories that attempt to explain the histogenesis of this rare entity. The theory of Mullerian heterotopia provides a plausible histogenetic explanation for the vast majority of CCC. A proposed alternative theory is the ciliated metaplasia of eccrine glands. We believe that previously reported cases of CCC include 2 distinct entities. We report, herein, the first case reported in the literature of a cutaneous ciliated eccrine cyst occurring on the scalp.
Assuntos
Cistos/patologia , Glândulas Écrinas/patologia , Couro Cabeludo/patologia , Biomarcadores/análise , Biópsia , Cistos/química , Cistos/cirurgia , Glândulas Écrinas/química , Glândulas Écrinas/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Metaplasia , Pessoa de Meia-Idade , Couro Cabeludo/química , Couro Cabeludo/cirurgiaAssuntos
Anodontia/genética , Glândulas Écrinas/anormalidades , Neoplasias Palpebrais/genética , Hipotricose/genética , Ceratodermia Palmar e Plantar/genética , Mutação de Sentido Incorreto/genética , Proteínas Wnt/genética , Anodontia/diagnóstico , Anodontia/cirurgia , Glândulas Apócrinas/cirurgia , Diagnóstico Diferencial , Glândulas Écrinas/cirurgia , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/cirurgia , Feminino , Heterozigoto , Hidrocistoma/diagnóstico , Hidrocistoma/genética , Hidrocistoma/cirurgia , Humanos , Hipotricose/diagnóstico , Hipotricose/cirurgia , Ceratodermia Palmar e Plantar/diagnóstico , Ceratodermia Palmar e Plantar/cirurgia , Pessoa de Meia-Idade , Fenótipo , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/genética , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
We recently observed atypical adenomatous metaplasia of eccrine glands in an excisional biopsy of squamous cell carcinoma (SCC). This led us to this study in an effort to ascertain whether this reaction pattern is common to all excisional biopsies and, depending on its presence in association with residual tumor, whether it is lineage specific. We performed a retrospective review of 201 excisional biopsies and noted that adenomatous metaplasia was present in 35 of 201 (17%) of the cases, of which 19 had residual tumor. Adenomatous metaplasia seemed to be more frequent in epithelial neoplasms such as basal cell carcinomas 15 of 94 (16%) and SCCs 13 of 61 (21%) although only (3 of 41) 7% of nevomelanocytic proliferations exhibited this change. Residual tumor was noted in association with adenomatous metaplasia, in 11 of 15 cases (73%) in the basal cell carcinoma subgroup, in 8 of 13 cases (62%) in the SCC subgroup, and in none from the nevomelanocytic subgroup. Comparing frequencies of adenomatous metaplasia across groups, only SCC specimens with residual tumor demonstrated a statistically significant increase compared with nevomelanocytic neoplasm (35% vs. 7%, P = 0.01). Findings from the current study expand the spectrum of metaplastic change involving eccrine glands to include adenomatous metaplasia. Given that it seems to be more common to epithelial malignancies, it seems reasonable to posit that this reaction pattern is the consequence of hitherto undefined proteins induced by epithelial tumor cells resulting in exuberant stimulation of eccrine glands, although immunohistochemical and molecular studies are required to define the precise cause.
Assuntos
Adenoma/patologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Glândulas Écrinas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Adenoma/cirurgia , Biópsia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Glândulas Écrinas/cirurgia , Humanos , Melanoma/patologia , Metaplasia , Neoplasia Residual/patologia , Nevo/patologia , Estudos Retrospectivos , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
Squamoid eccrine ductal carcinoma (SEDC) is an exceedingly rare tumor that shows both squamous differentiation and adnexal ductal differentiation. As our review of the literature revealed, only a total of 7 cases were reported to date. We report an additional case of SEDC occurring on the scalp of a 53-year-old man. Despite complete excision by conventional technique with clear margin, the lesion recurred within a 3-month period, with regional lymph node metastasis. The tumor was completely removed, and the large scalp defect was reconstructed by using scalp rotation flap. We present a case of recurrent SEDC on the scalp, and we surgically resected this tumor. In addition, the large scalp defect was reconstructed successfully with scalp flap, and no recurrence has been observed in the patient's postoperative follow-ups.
Assuntos
Carcinoma Ductal/cirurgia , Carcinoma de Células Escamosas/cirurgia , Glândulas Écrinas/cirurgia , Couro Cabeludo/cirurgia , Neoplasias das Glândulas Sudoríparas/cirurgia , Carcinoma Ductal/diagnóstico por imagem , Carcinoma Ductal/patologia , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Glândulas Écrinas/diagnóstico por imagem , Glândulas Écrinas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Couro Cabeludo/diagnóstico por imagem , Couro Cabeludo/patologia , Retalhos Cirúrgicos , Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem , Neoplasias das Glândulas Sudoríparas/patologia , Tomografia Computadorizada por Raios XRESUMO
Aggressive digital papillary adenocarcinoma (ADPA) is a rare neoplasm of eccrine sweat gland origin that typically presents as a mass on the distal extremities. It is associated with high rates of local recurrence and distal metastasis. Presented here is the case of a 61-year-old male who developed ADPA on his distal sole just above the head of the first metatarsal bone. Wide excision of the tumor involving a 3-cm skin margin from previous surgical scar of biopsy was performed, and sentinel lymph node biopsies were taken from the popliteal fossa and inguinal regions. During this wide excision surgery, the pedicle for the reverse medial plantar flap had to be removed along with the tumor. Reconstructive surgery was performed with a medial plantar flap that was vascularized with a lateral plantar artery in a reverse fashion. This flap successfully covered the defect and the patient can walk without any problems. However, the pedicle crossed the donor site somewhat tightly and the flap became congested for a while. Therefore, it is important to ensure careful handling of the donor site when performing this procedure.
Assuntos
Adenocarcinoma Papilar/cirurgia , Antepé Humano/cirurgia , Retalhos Cirúrgicos/irrigação sanguínea , Neoplasias das Glândulas Sudoríparas/cirurgia , Anastomose Cirúrgica , Glândulas Écrinas/patologia , Glândulas Écrinas/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Glândulas Écrinas/cirurgia , Hiperidrose/cirurgia , Adolescente , Adulto , Axila/cirurgia , Feminino , Humanos , Masculino , Satisfação do Paciente , Qualidade de Vida , Adulto JovemRESUMO
Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is an uncommon disease that presents early in childhood and is characterized by keratotic papules, often in a linear configuration. We describe a 12-year-old girl with characteristic lesions of PEODDN and describe her response to treatment with a combination CO2/Erbium laser. We also briefly review the literature on PEODDN.
Assuntos
Lasers de Gás/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Nevo/cirurgia , Poroceratose/cirurgia , Neoplasias Cutâneas/cirurgia , Axila , Criança , Glândulas Écrinas/patologia , Glândulas Écrinas/cirurgia , Feminino , Pé , Mãos , Humanos , Nevo/patologia , Poroceratose/patologia , Neoplasias Cutâneas/patologiaRESUMO
RATIONALE: Eccrine poroma, a benign cutaneous neoplasm originating from the intraepidermal portion of the eccrine sweat duct, is relatively common in clinical practice. Nevertheless, the 1 presenting as spindle-shaped plaque is extremely rare and easily misdiagnosed as seborrheic keratosis or other dermatoses. Thus, the current study demonstrates a case of eccrine poroma with unique clinical manifestation. PATIENTS CONCERNS: A 47-year-old man presented with a spindle-shaped plaque on his left sole for 6 years. DIAGNOSES: Based on the clinical and histopathological manifestations, diagnosis of eccrine poroma was established. INTERVENTIONS: Surgical excision under local anesthesia was performed. OUTCOMES: No recurrence or malignant transformation occurred within 6-month follow-up. LESSONS: Eccrine poroma typically presents as a dome-shaped nodule on palm or sole. But this case reminded us the lesion presenting as a spindle-shaped plaque on sole can not rule out the possibility of eccrine poroma.
Assuntos
Glândulas Écrinas/patologia , Poroma/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Glândulas Écrinas/cirurgia , Pé , Humanos , Masculino , Pessoa de Meia-Idade , Poroma/patologia , Poroma/cirurgia , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgia , Resultado do TratamentoRESUMO
The authors report a rare case of primary mucinous eccrine adenocarcinoma of the skin initially diagnosed as metastatic adenocarcinoma and treated with local excision and adjuvant radiotherapy in another center. The tumor reoccurred in the left axilla 2.5 years later after the initial treatment. Diagnosis in our center was primary cutaneous eccrine mucinous adenocarcinoma. We present the clinical, histological, and immunohistochemical features of this rare tumor in the light of the searched literature.
Assuntos
Adenocarcinoma Mucinoso/patologia , Axila/patologia , Glândulas Écrinas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Adenocarcinoma Mucinoso/cirurgia , Idoso , Axila/cirurgia , Glândulas Écrinas/cirurgia , Humanos , Masculino , Neoplasias das Glândulas Sudoríparas/cirurgia , Resultado do TratamentoAssuntos
Adenoma de Glândula Sudorípara/patologia , Glândulas Écrinas/patologia , Doenças do Pé/patologia , Doenças do Pé/cirurgia , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgia , Adenoma de Glândula Sudorípara/classificação , Adenoma de Glândula Sudorípara/cirurgia , Idoso , Diagnóstico Diferencial , Glândulas Écrinas/cirurgia , Humanos , Masculino , Dedos do Pé/patologia , Dedos do Pé/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND Syringoid eccrine carcinoma (SEC) is an extremely rare malignant adnexal neoplasm derived from eccrine sweat glands, of unknown pathogenesis. We report a case of this rare entity presenting in the abdomen, which is the only one reported in this area and the only case of SEC in a patient with so many comorbidities. CASE REPORT A 58-year-old black male from Brazil reported a nodular lesion in the abdomen with a progressive increase in size and pain and local burning sensation. The histopathological examination showed a syringoid eccrine carcinoma. CONCLUSIONS We present a rare case of SEC and did an extensive literature review in order to describe the clinical characteristics, histopathological findings, immunohistochemical profile, treatments, and difficulties found in the diagnosis of this tumor. To avoid misdiagnosis, we gave special attention to biopsy quality.
Assuntos
Parede Abdominal/patologia , Parede Abdominal/cirurgia , Carcinoma/cirurgia , Glândulas Écrinas/patologia , Glândulas Écrinas/cirurgia , Neoplasias das Glândulas Sudoríparas/cirurgia , Siringoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças RarasRESUMO
We present the case of a 54-year-old woman affected by a large perineal region eccrine porocarcinoma, with a wide local invasion. We discuss the clinical presentation and the imaging findings and review the literature.
Assuntos
Acrospiroma/patologia , Neoplasias do Ânus/patologia , Neoplasias dos Genitais Femininos/patologia , Imageamento por Ressonância Magnética/métodos , Períneo/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Acrospiroma/diagnóstico por imagem , Acrospiroma/cirurgia , Canal Anal/diagnóstico por imagem , Canal Anal/patologia , Canal Anal/cirurgia , Neoplasias do Ânus/diagnóstico por imagem , Neoplasias do Ânus/cirurgia , Colostomia , Meios de Contraste , Glândulas Écrinas/diagnóstico por imagem , Glândulas Écrinas/patologia , Glândulas Écrinas/cirurgia , Feminino , Seguimentos , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Neoplasias dos Genitais Femininos/cirurgia , Compostos Heterocíclicos , Humanos , Aumento da Imagem/métodos , Pessoa de Meia-Idade , Compostos Organometálicos , Períneo/diagnóstico por imagem , Períneo/cirurgia , Doenças Raras , Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem , Neoplasias das Glândulas Sudoríparas/cirurgia , Tomografia Computadorizada por Raios X , Vagina/diagnóstico por imagem , Vagina/patologia , Vagina/cirurgia , Vulva/diagnóstico por imagem , Vulva/patologia , Vulva/cirurgiaRESUMO
Squamoid eccrine ductal carcinoma is a cutaneous malignancy that originates from the eccrine sweat gland. A 76-year-old woman presented with an asymptomatic papule on her nose that had been present for one year. Dermoscopy showed pseudocysts, irregular linear crown vessels, and yellowish-brown globules surrounded by white halos. This is the first dermoscopic description of squamoid eccrine ductal carcinoma. Studies with more cases are needed to confirm the dermoscopic characterization of this tumor.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Glândulas Écrinas/patologia , Neoplasias Cutâneas/patologia , Idoso , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Dermoscopia , Diagnóstico Diferencial , Diagnóstico Precoce , Glândulas Écrinas/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgiaRESUMO
CASE REPORT: A 58-year-old white female noted a lesion on her left lower eyelid, present for 3 months. Examination disclosed a dark-blue, subepithelial, smooth mass along the cilia near the punctum. The lesion did not transmit light and was thought to be a solid mass, such as a deep-blue nevus or melanoma versus a cystic mass with internal debris. Ultrasound biomicroscopy showed a fairly circumscribed echolucent mass measuring 3.2 x 3.5 mm suggestive of a cyst with numerous internal echo impedances. Following resection, histopathologic evaluation disclosed a cyst lined by a dual layer of eccrine sweat ductal epithelium, consistent with eccrine hidrocystoma. COMMENTS: Eyelid hidrocystomas can be pigmented and can be confused clinically with melanocytic tumors. Ultrasound biomicroscopy can provide helpful diagnostic information about the internal architecture of such lesions.
Assuntos
Glândulas Écrinas/diagnóstico por imagem , Neoplasias Palpebrais/diagnóstico por imagem , Hidrocistoma/diagnóstico por imagem , Microscopia Acústica/métodos , Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem , Diagnóstico Diferencial , Glândulas Écrinas/patologia , Glândulas Écrinas/cirurgia , Neoplasias Palpebrais/patologia , Neoplasias Palpebrais/cirurgia , Feminino , Seguimentos , Hidrocistoma/patologia , Hidrocistoma/cirurgia , Humanos , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
Eccrine spiradenoma is one of the rare adnexal tumors with eccrine differentiation; however, it is considered to have apocrine differentiation. Around 50 cases of eccrine spiradenoma have been reported in the literature. Due to vascularity and painful symptoms, it is often confused with the painful lesions of skin such as glomus tumor and angioleiomyoma. Surgical excision is considered the gold standard for the treatment of these cases, with low rates of recurrence. Here, we present a 52-year-old male who presented with a nodular lesion in the left side of chest for the past 4 years. Surgical excision was performed and the tissue was sent for histopathological examination. Eccrine Spiradenoma may present congenitally or spontaneously as tumor of the sweat glands with unclear etiology. Early accurate diagnosis is very important in preventing chances of recurrence and more importantly identifying onset of malignant transformation.