RESUMEN
Nodular hidradenoma is an infrequent benign tumor originating from the proximal portion of the sweat glands, most commonly associated with the apocrine glands. Owing to its variable clinical presentation, correctly diagnosing nodular hidradenoma can be challenging, with several potential conditions in the differential diagnosis to consider. This article presents a healthy 52-year-old woman with an atypical location of nodular hidradenoma, highlighting the critical role of integrating clinical, dermoscopic, and histopathological characteristics for an accurate diagnosis. We discuss the clinical features, dermoscopic findings, histological examination, differential diagnosis, and treatment options for nodular hidradenoma, emphasizing the importance of surgical intervention in preventing potential malignant transformation.
Asunto(s)
Acrospiroma , Dermoscopía , Neoplasias de las Glándulas Sudoríparas , Humanos , Femenino , Persona de Mediana Edad , Neoplasias de las Glándulas Sudoríparas/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Acrospiroma/patología , Acrospiroma/diagnóstico , Diagnóstico DiferencialRESUMEN
Eccrine acrospiroma is a rare benign tumor of the skin arising from the epithelial cells of eccrine sweat ducts. The clinical picture is characterized by its variability, so a detailed morphological study of the operative material is necessary to establish a diagnosis. Differential diagnosis must be carried out with hemangioma, melanoma, infected sebaceous cyst, metastatic skin lesion, and other tumors from elements of the sweat gland. In the article the authors presented the clinical and morphological analysis of own case from practice of large eccrine acrospiroma on the back surface of the left thigh which was diagnosed in a 56-year-old man.
Asunto(s)
Acrospiroma , Neoplasias de las Glándulas Sudoríparas , Humanos , Masculino , Persona de Mediana Edad , Diagnóstico Diferencial , Neoplasias de las Glándulas Sudoríparas/patología , Acrospiroma/patología , Acrospiroma/diagnóstico , Glándulas Ecrinas/patología , Muslo/patologíaRESUMEN
Clear cell hidradenoma is a rare benign tumor of the breast, its origin and pathogenesis are controversial. We have experienced a case of breast clear cell hidradenoma with mastermind like transcriptional coactivator 2 (MAML2) gene rearrangement. The patient found a painless mass with a hard texture in the left breast areola without nipple discharge. Microscopically, the tumor was cystic and solid, locally arranged in a glandular structure, covered by single cuboidal cells; it was composed of clear cells, epidermoid cells, and basaloid cells; there were no necrosis or mitotic figures. Immunohistochemical staining showed that the tumor cells positively expressed low-molecular cytokeratin 7, low-molecular cytokeratins (Cam5.2), high-molecular cytokeratin 5/6, cytokeratin 14, CD117, and p63; and did not express calponin, and smooth muscle myosin heavy chain. The cuboidal cells were positive for SOX10 but negative for p63. Additionally, periodic acid-Schiff reaction showed purple-red granules in the tumor cytoplasm, but Alcian blue staining showed no blue mucus in the cytoplasm. The split signals of MAML2 gene were detected by fluorescence in situ hybridization. Subtle histological and immunophenotypical differences may help to distinguish breast clear cell hidradenoma from common breast tumors. Furthermore, the MAML2 gene rearrangement may be a molecular genetic characteristic of breast clear cell hidradenoma.
Asunto(s)
Biomarcadores de Tumor , Neoplasias de la Mama , Proteínas de Unión al ADN , Reordenamiento Génico , Transactivadores , Factores de Transcripción , Humanos , Femenino , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Factores de Transcripción/genética , Transactivadores/genética , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/análisis , Hibridación Fluorescente in Situ , Neoplasias de las Glándulas Sudoríparas/genética , Neoplasias de las Glándulas Sudoríparas/patología , Proteínas Nucleares/genética , Adenoma de las Glándulas Sudoríparas/patología , Adenoma de las Glándulas Sudoríparas/genética , Adenoma de las Glándulas Sudoríparas/metabolismo , Persona de Mediana Edad , Inmunohistoquímica , Acrospiroma/patología , Acrospiroma/genética , Acrospiroma/diagnósticoRESUMEN
BACKGROUND: Hidradenocarcinoma (HAC) is a rare adnexal carcinoma. To the best of the authors' knowledge, there are no published systematic reviews on HAC. OBJECTIVE: To incorporate a case series from the authors' institution and systematically integrate reported information to provide a reference tool for optimization of diagnosis and management. METHODS: A comprehensive MEDLINE search was conducted from database inception to 2021 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This yielded 225 studies with 165 cases of HAC. References of included articles were also searched. In addition, 9 patients with HAC were identified from the authors' institution over the past 10 years. RESULTS: The mean age of HAC presentation is 60 years with a slight male predilection (60%). The head and neck is the most commonly affected region. Over 36% of cases either presented with metastatic disease or went on to metastasize. The most common treatment type was wide local excision, followed by Mohs micrographic surgery. CONCLUSION: Early detection with accurate histologic interpretation is prudent in all cases of HAC. Wide local excision is the current first-line treatment. However, Mohs micrographic surgery offers complete marginal analysis with evidence of reduced risk of metastasis and better outcomes compared with wide local excision. Currently, there are no National Comprehensive Cancer Network guidelines for the treatment of HAC, and consensus guidelines are limited to tumor and nodal metastasis staging provided by the American Joint Committee on Cancer, eighth edition. Thus, this case series and systematic review integrates important aspects of diagnosis, workup, and management of HAC.
Asunto(s)
Cirugía de Mohs , Neoplasias de las Glándulas Sudoríparas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Acrospiroma/patología , Acrospiroma/diagnóstico , Acrospiroma/cirugía , Neoplasias de las Glándulas Sudoríparas/patología , Neoplasias de las Glándulas Sudoríparas/cirugía , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/terapiaRESUMEN
ABSTRACT: Digital papillary adenocarcinoma is a malignant adnexal tumor with a predilection for acral sites. Hidradenoma is a benign solid and cystic sweat gland neoplasm with focal ductal and glandular differentiation and good outcomes. Hidradenomas can occur at acral sites and show papillary structures; for this reason, they are included in the differential diagnosis of digital papillary adenocarcinoma, and immunohistochemistry is a valuable tool in this scenario. We described a case of a 43-year-old man with an epithelial tumor showing papillary structures in the intermediate phalanx of the fourth finger. There was diffuse positivity for p63 and negativity for S100 protein, suggesting that this tumor was an acral hidradenoma with papillary structures.
Asunto(s)
Acrospiroma , Adenocarcinoma de Células Claras , Adenocarcinoma Papilar , Adenoma de las Glándulas Sudoríparas , Neoplasias Óseas , Neoplasias de la Mama , Carcinoma de Apéndice Cutáneo , Neoplasias Cutáneas , Neoplasias de las Glándulas Sudoríparas , Acrospiroma/diagnóstico , Acrospiroma/cirugía , Adenocarcinoma Papilar/química , Adenocarcinoma Papilar/diagnóstico , Adenocarcinoma Papilar/cirugía , Adenoma de las Glándulas Sudoríparas/patología , Adulto , Humanos , Inmunohistoquímica , Masculino , Proteínas S100 , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/metabolismo , Neoplasias de las Glándulas Sudoríparas/cirugíaRESUMEN
Digital papillary adenocarcinoma (DPAC) is a rare tumor of sweat gland origin that preferentially affects the digits and has the potential to metastasize. Its tumor diagnosis can be difficult. Well-differentiated variants of DPAC can be confused with a benign sweat gland tumor, in particular nodular hidradenoma. With the recent detection of HPV42 DNA in DPAC by next-generation sequence analysis, we reasoned that this association could be used for diagnostic purposes. To this end, we performed in situ hybridization for HPV42 on 10 tumors diagnosed as DPAC as well as 30 sweat gland tumors of various histology types, including 8 acral hidradenomas. All DPAC were positive for HPV42. Positive hybridization signals for HPV42 were seen in both primary and metastatic DPACs. All other tumors and normal tissues were negative. This study confirms the association of HPV42 with the tumor cells of DPAC through in situ hybridization. The positive test result in all lesions of DPAC and lack of detection of HPV42 in any of the acral hidradenomas or other sweat gland tumors examined in this series is encouraging for the potential diagnostic utility of the assay. As documented by two scrotal tumors of DPAC, the in situ hybridization test for HPV42 can also help support the rare occurrence of this tumor at a non-acral site.
Asunto(s)
Acrospiroma , Adenocarcinoma de Células Claras , Adenocarcinoma Papilar , Adenoma de las Glándulas Sudoríparas , Neoplasias Óseas , Neoplasias de la Mama , Neoplasias de Tejido Conjuntivo , Neoplasias de las Glándulas Sudoríparas , Acrospiroma/diagnóstico , Acrospiroma/genética , Acrospiroma/patología , Adenocarcinoma Papilar/patología , Adenoma de las Glándulas Sudoríparas/diagnóstico , Adenoma de las Glándulas Sudoríparas/patología , Femenino , Humanos , Hibridación in Situ , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/genética , Neoplasias de las Glándulas Sudoríparas/patologíaAsunto(s)
Acrospiroma , Carcinoma Adenoide Quístico , Neoplasias de las Glándulas Sudoríparas , Acrospiroma/diagnóstico , Acrospiroma/patología , Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/patología , Humanos , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/patologíaRESUMEN
Solid-cystic hidradenoma is a benign cutaneous tumor that is most commonly found in the head, neck, trunk, and upper extremity regions of patients in the middle to older aged groups. Presentation on lower extremities and in particular on the foot is uncommon. Nodular hidradenomas represent a dermatological pitfall, being difficult to differentiate from basal cell carcinoma and melanoma. We report on a 53-year-old male patient with a pigmented nodular hidradenoma on his ankle that was surgically removed. We discuss histopathology and differential diagnosis of this eccrine tumor of skin. This is the second reported case in the English literature.
Asunto(s)
Acrospiroma , Carcinoma Basocelular , Neoplasias Cutáneas , Neoplasias de las Glándulas Sudoríparas , Acrospiroma/diagnóstico , Acrospiroma/cirugía , Tobillo/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/cirugíaRESUMEN
Hidradenoma are rare benign tumors with eccrine or apocrine differentiation that most often presents as a small, firm, solitary dermal nodule. At times, hidradenoma shows striking cytologic and histologic similarity to other neoplasms, including its malignant counterpart, hidradenocarcinoma. We present the first reported case of benign hidradenoma of the lower lip. The case illustrates important diagnostic features of hidradenoma and discusses the current understanding of its malignant potential and the appropriate management of such lesions.
Asunto(s)
Acrospiroma/patología , Acrospiroma/cirugía , Neoplasias de los Labios/patología , Neoplasias de los Labios/cirugía , Enfermedades Raras , Acrospiroma/diagnóstico , Adulto , Femenino , Humanos , Neoplasias de los Labios/diagnóstico , Resultado del TratamientoRESUMEN
Malignant eccrine spiradenoma is an extremely rare neoplasm of adnexal origin. It almost always originates from a preexisting long standing eccrine spiradenoma. We present a case of malignant eccrine spiradenoma arising from benign counterpart and having both carcinomatous and sarcomatous differentiation. Here we present a case of a 46 years old lady who presented with a long standing small nodule on her left leg of 7 years' duration with suddenly increase in size. Grossly the mass was partly solid and partly cystic measuring 11.5 cm in maximum dimension with cystic area forming the deeper plane. On microscopy, the superficial dermis showed well demarcated lobules of benign eccrine spiradenoma. Deeper dermis showed tumor cells with features of malignant transformation having both carcinomatous and sarcomatous component. After wide local excision patient is now doing well. The diagnosis of malignant eccrine spiradenoma requires a thorough histopathological examination of the lesion and requires finding a focus of benign spiradenoma within or adjacent to malignant tumour. Wide local excision and close follow-up for early detection of recurrence and metastasis is the mostly recommended management modality.
Asunto(s)
Acrospiroma/diagnóstico , Acrospiroma/patología , Carcinosarcoma/diagnóstico , Carcinosarcoma/patología , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/patología , Dermis/patología , Diagnóstico Diferencial , Femenino , Humanos , Pierna/patología , Persona de Mediana Edad , Glándulas Sudoríparas/patologíaRESUMEN
DICER1 tumor predisposition syndrome is a rare genetic disorder that predisposes individuals to multiple benign and malignant neoplasms. The phenotype is vast and includes pleuropulmonary blastoma (PPB), thyroid nodules, cystic nephroma, Wilms tumor, ovarian Sertoli-Leydig cell tumor, and medulloepithelioma, among others. Herein, we describe a patient with a DICER1 germline pathogenic variant presenting with two neoplasms that are not commonly encountered in the context of DICER1 syndrome. The first tumor is a multiloculated cystic hepatic lesion with a biphasic pattern, composed of cysts lined by bland biliary type (CK19-positive) epithelium surrounded by a condensation of sarcomatous spindled cell proliferation in a myxoid stroma. This neoplasm resembled PPB or cystic nephroma with malignant transformation. The second tumor is a chest nodule consistent with low-grade hidradenocarcinoma. Although it is difficult to speculate with just a single case, these unusual neoplasms occurring in particular at a young age raises the possibility that they can be inherent to, and thus, be part of the DICER1 tumor predisposition syndrome phenotype.
Asunto(s)
Acrospiroma/diagnóstico , Biomarcadores de Tumor/genética , ARN Helicasas DEAD-box/genética , Neoplasias Hepáticas/diagnóstico , Síndromes Neoplásicos Hereditarios/diagnóstico , Ribonucleasa III/genética , Sarcoma/diagnóstico , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Acrospiroma/genética , Adolescente , Niño , Femenino , Humanos , Neoplasias Hepáticas/genética , Mutación , Síndromes Neoplásicos Hereditarios/genética , Fenotipo , Sarcoma/genética , Neoplasias de las Glándulas Sudoríparas/genética , Adulto JovenAsunto(s)
Acrospiroma/diagnóstico , Adenocarcinoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Acrospiroma/patología , Acrospiroma/cirugía , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Anciano de 80 o más Años , Procedimientos Quirúrgicos Dermatologicos , Femenino , Humanos , Pierna/patología , Pierna/cirugía , Piel/patología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
We report a case of clear cell hidradenoma of the perineum that was initially misinterpreted as a papillary urothelial carcinoma, either metastatic or of Bartholin gland origin, on initial excisional biopsy. The misinterpretation may have been due to the pseudopapillary architecture and GATA3-positivity of the biopsy tissue. Clear cell hidradenomas often show a range of histologic growth patterns and cellular differentiation and are one of many tumors that react immunohistochemically with GATA3. Although rare, these tumors can occur in the genital region and can mimic malignant tumors such as metastatic renal cell carcinoma and carcinomas of the genitourinary tract. This report details the morphologic and immunohistochemical pitfalls that make accurate diagnosis of clear cell hidradenoma in this unusual location challenging.
Asunto(s)
Acrospiroma/diagnóstico , Factor de Transcripción GATA3/metabolismo , Neoplasias Renales/diagnóstico , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Acrospiroma/patología , Biopsia , Errores Diagnósticos , Femenino , Humanos , Inmunohistoquímica , Neoplasias Renales/patología , Persona de Mediana Edad , Perineo/patología , Neoplasias de las Glándulas Sudoríparas/patologíaRESUMEN
Hidradenoma is a rare benign neoplasm, with few cases reported to involve the eyelid. When affecting the eyelid, hidradenomas may mimic other benign or malignant lesions. Rarely, a benign hidradenoma may transform into a malignant hidradenoma and metastasize. The authors present a case of a benign hidradenoma arising from the eyelid, presenting with rapid growth, ulceration, and bleeding, suggestive of a malignant lesion.
Asunto(s)
Acrospiroma , Adenocarcinoma de Células Claras , Adenoma de las Glándulas Sudoríparas , Neoplasias de las Glándulas Sudoríparas , Acrospiroma/diagnóstico , Acrospiroma/cirugía , Párpados/cirugía , Humanos , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Neoplasias de las Glándulas Sudoríparas/cirugíaAsunto(s)
Acrospiroma/diagnóstico , Carcinoma Mucoepidermoide/diagnóstico , Neoplasias de las Glándulas Sudoríparas/diagnóstico , Glándulas Sudoríparas/patología , Acrospiroma/patología , Carcinoma Mucoepidermoide/patología , Diagnóstico Diferencial , Humanos , Clasificación del Tumor , Neoplasias de las Glándulas Sudoríparas/patologíaRESUMEN
Clear cell hidradenoma (CCH) is a tumour originating from the eccrine sweat glands. It usually presents in the limbs, axilla or trunk. CCH of the breast is rare and can present as a cystic lesion in the breast that can be easily misdiagnosed as malignancy. We report a 36-year-old female patient who presented at the Sultan Qaboos University Hospital Breast Clinic, Muscat, Oman, in 2018 with a lump in her left breast. Ultrasound examination reported a complex cystic lesion with a solid, vascular component. An ultrasound-guided core needle biopsy was suggestive of clear cell hidradenoma. Surgical excision was performed and histopathology confirmed the diagnosis of CCH of the breast. This is the first ever case of a diagnosis of CCH made using core needle biopsy. CCH can be challenging to diagnose; therefore, awareness of its histopathological and ultrasonographic features are essential to avoid misdiagnosis and over treatment.