Case for diagnosis. A bluish nodule on the scalp.

Acrospiroma, also known as hidradenoma, is a rare cutaneous tumor that has several histological characteristics. As a consequence, a high index of suspicion is necessary for its diagnosis. Here we report a case that illustrates the importance of a good clinical-pathologic correlation in order to recognize this disease.

Case for diagnosis. A bluish nodule on the scalp

Abstract: Acrospiroma, also known as hidradenoma, is a rare cutaneous tumor that has several histological characteristics. As a consequence, a high index of suspicion is necessary for its diagnosis. Here we report a case that illustrates the importance of a good clinical-pathologic correlation in order to recognize this disease.

[Hidradenoma papilliferum. Report of two cases and review of literature]. / Hidradenoma papilífero. Reporte de dos casos y revisión de la bibliografía.

We bring two cases of hidradenoma papilliferum, rare injury. We describe the clinical, histopathological and a review of the available literature on the condition.

Immunophenotypic aspects of cylindroma and nodular hidradenoma.

BACKGROUND: Some adnexal tumours have many controversies about their histogenesis. OBJECTIVES: To evaluate the eccrine and/or apocrine differentiation phenotype in cases of cylindroma and clear cell hidradenoma with CD15 and p63 antibodies. METHODOLOGY: Slides and blocks of six cases of cylindroma and seven cases of nodular hidradenoma (clear cells) were analyzed by the technique of immunohistochemistry with CD15 and p63 antibodies. RESULTS: In all cases of cylindroma we obtained negative results for CD15 antibody and positive for p63 antibody. In five of seven cases of nodular hidradenoma (clear cell), we could easily observe clear cells between 20% and 50% of tumour cells. In the two other cases, cystic lesions were present and occasional clear cells could be seen. The reaction with CD15 antibody was positive in granular and cytoplasmic pattern in six of seven cases, especially in cells with suggestive clear cytoplasm in lower proportion than this clear cells could be seen in haematoxylin and eosin. The positivity for p63 antibody, nuclear pattern, was observed in six of seven cases, in the major part of tumour cells. In only one case, the positivity was in 20% of cells. Limitation Samples are in small number because these are relatively rare tumours. CONCLUSIONS: The present study suggests eccrine origin for both tumours: cylindroma and clear cell hidradenoma.

Espiroadenoma ecrino de presentación inusual en párpado / Eccrine spiradenoma of inusual presentation on the eyelid

Reportamos el caso de un espiroadenoma ecrino en una paciente de 90 años de edad, que empezó un año antes de la consulta con una lesión en el párpado. Se trata de un tumor benigno de la glándulas sudoríparas que es raro en el párpado. Al principio pensamos en otro tumor, como el carcinoma sebáceo, por su rápido crecimiento. La posibilidad de un tumor de glándulas sudoríparas debiera considerarse en el diagnóstico de tumores palpebrales.

We report a case of an eccrine spiradenoma in a 90 years old woman, who began a year before with the lesion on the eyelid. It is a begin sweat gland tumor, that is rare on the eyelid. At the beginning we thougth in an other tumor, like sebaceous carcinoma for its quick growth. The possibility of sweat gland tumor should be kept in mind in the diagnosis of eyelid tumours.

Correlación clínico-patológica de poromas / Clinical-pathological correlation of poromas

Introducción: Poroma es un tumor benigno, del conducto excretor de las glándulas suporíparas. El diagnóstico diferencial es amplio: porocarcinoma, granuloma telangiectásico, melanoma, etc. Objetivos: Determinar la correlación clínico-patológica de los pacientes con diagnósticos de poroma durante los años 1994-2003 en el Centro de Histodiagnósticos Málaga, Santiago de Chile y la ubicación de estas lesiones. Materiales y Métodos: Se analizaron retrospectivamente 37.500 biopsias entre los años 1994-2003, seleccionando aquellas con diagnóstico histopatológico de poroma. Se analizó la ubicación, diagnóstico clínico de derivación y la correlación clínico-patológica. Resultados: El 0,1 por ciento de las biopsias examinadas tenía el diagnóstico de poroma. La ubicación clínica más frecuentes fue: pie (27 por ciento), muslo y pierna (20 por ciento), tórax (8 por ciento). Los diagnósticos clínicos de derivación fueron: granuloma telangiectásico (19 por ciento), angioma (8 por ciento), tumor benigno (8 por ciento), nevo (8 por ciento). Conclusiones: Sólo un 7,5 por ciento del total de biopsias con diagnóstico histológico de poroma, tuvieron diagnóstico clínico concordante.

[Clear-cell eccrine carcinoma of the plantar region. Follow-up of a case using histochemistry, immunohistochemistry, and flow cytometry]. / Carcinoma ecrino de células claras en región plantar. Seguimiento de un caso por histoquímica, immunohistoquímica y citometría de flujo.

Clear cell eccrine carcinomas of the skin are rare and have been reported with several names. Of the 47 cases found in the literature, only one had the lesion in the sole. The present case is a 38 year old woman with an 18 year history of a 3.2 cm lesion in the lateral portion of the sole in the right foot. The patient developed inguinal metastases four and five months after the plantar resection, and suffered a local recurrence on two occasions. The histopathologic analysis of the sole lesion showed a neoplasm with more than 80% of clear cells, and less clear cells in the metastatic and recurrent lesions. Clear cells showed diffuse positivity to PAS with diastase lability. PAS reactivity was related to the presence of clear cells. Focal reactivity of mucin and colloidal iron in sebaceous-like cells and tubular structures was seen. Also, we found diffuse cytoplasmic and membrane surface positivity of epithelial membrane antigen in the clear cells, and focal in poroid and sebaceous cells and in tubular structures. The carcinoembryonic antigen showed a focal positivity in poroid and sebaceous cells and in tubular structures. We also identified focal positivity of S-100 protein in the sebaceous-like cells. Cytophotometric measurement of the nuclear DNA showed euploid cells in the primary and metastatic lesions. We conclude that clear cell eccrine carcinomas comprise a heterogeneous group of lesions with variable biological behavior, but with morphological, histochemical and immunohistochemical markers useful in their diagnosis.

Poroma écrino: relato de caso e revisäo de literatura / Eccrine Poroma: a case report and literature review

Este relato apresenta um caso de poroma écrino, uma neoplasia benigna e incomum da glândula sudorípara, localizado no torax de um menino de treze anos. Como os tumores anexiais têm classificaçöes controversas, os autores também fazem uma revisäo da literatura sobre poroma écrino abordando os mais recentes achados no seu diagnóstico e tratamento. O tumor apresentado neste relato chama a atençäo näo apenas pelo seu tamanho e pela idade do paciente mas também pelo local encontrado

Poroma écrino maligno: relato de caso e revisäo da literatura / Malignant eccrine poroma: case report and review of the literature

Eccrine porocarcinoma is a rare tumor of eccrine sweat ducts of the skin. We report a case successfully treated surgically. These tumors hardly have a typical clinical appearance but is easily recognizable histologically. Three morfological variants can be identified: a benign, a premalignant or dysplastic, and an invasive, malignant form. Symptoms such as bleeding, pain and itching are sugestive of a possible malignant transformation. Primary treatment is wide surgical excision. The value of adjunctive therapy has not been proved. Our report and review of the literature illustrate the natural history and pathological finding of this disease