Value of Immunohistochemistry to Differentiate Digital Papillary Adenocarcinoma From Acral Hidradenoma With Papillary Structures.

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.

Siringocistoadenoma papilífero: reporte de 11 casos del Hospital Clínico de la Universidad de Chile / Papilliferum Syringocystoadenoma: report of 11 cases of Clinical Hospital of the University of Chile

Introducción: El siringocistoadenoma papilífero (SP) es un tumor anexial benigno inusual, de etiología desconocida. Por lo general, se presenta desde el nacimiento, o en la primera infancia como una lesión aislada, frecuentemente asociada a un nevo sebáceo de Jadassohn. Objetivo: Describir y analizar las características demográficas, clínicas e histopatológicas del SP. Materiales y métodos: Revisión retrospectiva de informes histopatológicos del Departamento de Anatomía Patológica del Hospital Clínico de la Universidad de Chile entre los años 2005 y 2016. Se incluyeron todas las muestras que describieron dentro del diagnóstico histológico las palabras "siringocistoadenoma papilífero". Resultados: La muestra está compuesta por 11 pacientes; 9 mujeres y 2 hombres. En 5 pacientes, se desarrolló un SP a partir de un nevo sebáceo y en 6 surgió de novo. El total de la muestra desarrolló el SP durante o posterior a la pubertad. Tanto los pacientes con SP solitario, como aquellos asociados a un nevo sebáceo, presentaron clínica similar con una placa o pápula verrucosa aislada. Los principales diagnósticos diferenciales fueron el nevo sebáceo, nevo verrucoso y verruga. Conclusiones: Este estudio constituye la primera serie de casos de SP en un hospital en Santiago de Chile. La forma clínica más frecuente fue como placa verrucosa solitaria asintomática, con casos aislados como pápula verrucosa y sólo un caso con aspecto de cuerno cutáneo. Se destaca el rol de la extirpación quirúrgica completa, tanto para establecer el diagnóstico, como para ofrecer un tratamiento definitivo, disminuyendo el riesgo de transformación maligna a siringocistoadenocarcinoma papilífero.

Introduction: Syringocystoadenoma papilliferum (SCAP) is an unusual benign adnexal tumor of unknown etiology. Usually it is presented at birth or in early childhood as an isolated lesion associated with nevus sebaceous of Jadassohn. Objective: To describe and analyze the demographic, clinical and histopathological characteristics of SCAP. Materials and methods: A retrospective review of histopathological reports was performed at the Clinical Hospital´s Department of Pathological Anatomy from the University of Chile including biopsies from 2005 to 2016. All the samples that described the histological diagnosis of "syringocystoadenoma papilliferum" were included. Results: The sample consists of 11 patients; 9 women and 2 men. In 5 patients, an SCAP was developed from a sebaceous nevus and in 6 it developed de novo. The total sample developed SCAP during or after puberty. Both the patients with solitary SCAP, and those associated with nevo sebaceous, presented similar clinical signs with an isolated verrucous plaque or papule. The main differential diagnoses were the nevo sebaceous, warty nevus and wart. Conclusions: This study is the first SCAP case series in Santiago, Chile. The most frequent clinical form was an asymptomatic solitary verrucous plaque, with isolated cases as a verrucous papule and a single case as a cutaneous horn. The role of complete surgical resection is highlighted, both to establish the diagnosis and to offer a definitive treatment, reducing the risk of malignant transformation to syringocystadenocarcinoma papilliferum.

Eyelid apocrine hidrocystomas in a cat

Background: Eyelid apocrine hidrocystoma (AH) is a benign cystic lesion originating from the glands of Moll. These eyelid lesions are rare in cats and there are few cases reported in the literature. The aetiopathogenesis of AH is unknown and the lesion has been interpreted either as proliferative adenomatous tumour or as retention cyst. Definitive diagnosis requires biopsy with microscopic examination. Treatment options for eyelid AH include surgical excision, drainage through aspiration, cryosurgery with liquid nitrogen and chemical ablation. The aim is to report a case of bilateral multiple AH of the eyelids in a cat that was successfully treated with surgical excision. Case: A 5-year-old male Himalayan cat was referred to the Ophthalmology Section in the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil with a history of pigmented masses in both eyes that had been progressively enlarging over a 1-year period. Ophthalmic examination revealed two cysts on the medial canthus at the eyelid margin in both eyes. In the left eye was observed mild blepharospasm and lacrimation. Cysts were soft, smooth, round and filled with a dark brownish pigment. The remainder of the ophthalmic examination was unremarkable. Surgical excision of the cysts was indicated with a safety margin. The surgical procedure was performed under [...]

Eyelid apocrine hidrocystomas in a cat

Background: Eyelid apocrine hidrocystoma (AH) is a benign cystic lesion originating from the glands of Moll. These eyelid lesions are rare in cats and there are few cases reported in the literature. The aetiopathogenesis of AH is unknown and the lesion has been interpreted either as proliferative adenomatous tumour or as retention cyst. Definitive diagnosis requires biopsy with microscopic examination. Treatment options for eyelid AH include surgical excision, drainage through aspiration, cryosurgery with liquid nitrogen and chemical ablation. The aim is to report a case of bilateral multiple AH of the eyelids in a cat that was successfully treated with surgical excision. Case: A 5-year-old male Himalayan cat was referred to the Ophthalmology Section in the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil with a history of pigmented masses in both eyes that had been progressively enlarging over a 1-year period. Ophthalmic examination revealed two cysts on the medial canthus at the eyelid margin in both eyes. In the left eye was observed mild blepharospasm and lacrimation. Cysts were soft, smooth, round and filled with a dark brownish pigment. The remainder of the ophthalmic examination was unremarkable. Surgical excision of the cysts was indicated with a safety margin. The surgical procedure was performed under [...](AU)

Retalho fasciocutâneo torácico lateral para reconstrução de defeitos axilares após ressecção de hidradenite supurativa: série de 10 casos / Lateral thoracic fasciocutaneous flap for reconstruction of axillary defects after resection of hidradenitis suppurativa: a series of 10 cases

INTRODUÇÃO: A hidradenite supurativa (HS) é uma inflamação folicular crônica que apresenta quadro clínico variado, desde pequenos nódulos isolados até diversas lesões abscedadas, com formação de fístulas e cicatrizes. A região axilar é uma das áreas mais frequentemente acometidas. O objetivo é analisar uma série de casos acometidos por HS na região axilar, submetidos à exérese cirúrgica ampliada e reconstrução com retalho fasciocutâneo torácico lateral. MÉTODOS: Análise retrospectiva dos prontuários dos pacientes submetidos a tratamento no período entre 2010 e 2012. RESULTADOS: Dez pacientes foram operados, sendo que em dois havia acometimento bilateral, totalizando 12 procedimentos. Foi observado um tempo médio de evolução antes da indicação cirúrgica de 38 meses. O defeito médio observado após a ressecção foi de 10 x 9 cm. O tamanho médio dos retalhos foi de 15 x 10 cm. Em relação às complicações precoces, foram observados dois casos de deiscência (região axilar) e um caso de epiteliólise parcial (segmento distal do retalho). CONCLUSÃO: Observamos que a dissecção deste retalho não é tecnicamente difícil e que não apresenta sequelas funcionais ou estéticas significativas na área doadora, sendo uma opção confiável e versátil para reconstrução de defeitos axilares de maior porte.

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic follicular inflammation that presents varied clinical features, from isolated small nodules to several abscessed lesions, with formation of fistulas and scars. The axillary region is one of the most frequently affected areas. The objective is to evaluate a series of patients with HS in the axillary region who underwent extensive surgical excision and reconstruction with a lateral thoracic fasciocutaneous flap. METHODS: A retrospective analysis of the medical records of patients who underwent treatment between 2010 and 2012 was conducted. RESULTS: Ten patients were operated, of whom two had bilateral involvement, totaling 12 procedures. The mean progression time before the surgical indication was 38 months. The mean defect size after the resection was 10 x 9 cm. The mean size of the flaps was 15 x 10 cm. With regard to early complications, two cases of dehiscence (axillary region) and one case of partial epitheliolysis (distal segment of the flap) were observed. CONCLUSION: We observed that dissection of lateral thoracic fasciocutaneous flaps is not technically difficult and does not present significant functional or aesthetic sequelae in the donor area, making it a reliable and versatile option for reconstruction of larger axillary defects.

Abordagem de hidrocistomas palpebrais écrinos por incisão de blefaroplastia inferior / Excision of eyelid eccrine hidrocystomas via lower blepharoplasty incision

INTRODUÇÃO: O hidrocistoma palpebral écrino corresponde a lesão cística rara, usualmente de pequenas dimensões, não ultrapassando o diâmetro de 10 mm. Sua abordagem usualmente é por excisão simples e biópsia. É alto o índice de recidiva local. MÉTODOS: Paciente com múltiplos hidrocistomas bilaterais, vários maiores que 10 mm. Sob anestesia local, foi realizada incisão infraciliar tradicionalmente usada para blefaroplastia inferior e retirada dos hidrocistomas com cápsula íntegra. RESULTADOS: Paciente com excelentes resultados estéticos e sem recidivas até o presente momento, mais de seis meses após o procedimento. CONCLUSÃO: A incisão infraciliar de blefaroplastia inferior é uma técnica promissora para exérese de hidrocistomas maiores que 10 mm. Mais estudos devem ser realizados para confirmação do bom resultado estético-funcional desta técnica.

INTRODUCTION: Eccrine eyelid hidrocystoma is a rare cystic lesion, usually small and not exceeding 10 mm in diameter. Its treatment is usually by simple excision and biopsy. The rate of local recurrence is high. METHODS: A patient presented with multiple bilateral hidrocystomas, several larger than 10 mm. Under local anesthesia, an infraciliary incision traditionally used for lower blepharoplasty was performed, and hidrocystomas with intact capsules were withdrawn. RESULTS: The patient had excellent esthetic results, with no recurrence for more than six months after the procedure. CONCLUSION: The infraciliary lower blepharoplasty incision is a promising technique for excising hidrocystomas larger than 10 mm. More studies should be conducted to confirm the good esthetic and functional outcomes of this technique.

Siringomas múltiples eruptivos / Multiple eruptive syringoma

Los siringomas son nevos benignos derivados del epitelio ductal intraepidermico de las glándulas sudoríparas ecrinas (acrosiringio). Predomina en mujeres y la variedad más frecuente es la de localización palpebral. La forma eruptiva es rara. Presentamos un varón de 29 años de edad, con siringomas múltiples eruptivos y compromiso en cara, antebrazos,abdomen y muslos con poca respuesta a tretinoína...

Siringomas múltiples localizados: a propósito de un caso / Syringoma multiple locales: a report of a case

Los siringomas son tumores anexiales benignos que derivan del conducto sudoríparo ecrino. Suelen presentarse luego de la pubertad, con mayor incidencia en el sexo femenino. Se manifiestan clínicamente como pápulas rosadas pequeñas, localizadas en cara, cuello y región del escote. Las mismas son asintomáticas, aunque ciertos pacientes pueden referir prurito. La anatomía patológica de la lesión se caracteriza por proliferaciones epiteliales de dos líneas de células y, según el plano de corte, se puede observar la clásica imagen “en cola de renacuajo”. Existen numerosas alternativas terapéuticas para su tratamiento, si bien ninguna de ellas es totalmente satisfactoria. Presentamos el caso de una paciente adolescente, evaluada en nuestro servicio, con siringomas múltiples localizados.

Syringomas are benign adnexal tumors derived from eccrine duct. They occur predominantly after puberty with higher incidence in females. Clinically, they present as small rose-colored papules usually localized on the face, neck and upper aspect of chest. The lesions are generally asymptomatic, although some patients may complain of pruritus. Histopathology it is characterized by epithelial proliferation of two cell layers and, depending upon the plane of section, the classic tadpole appearance may be observed. Numerous treatment options exist, none of which are totally satisfactory. We report a case of a female adolescent with multiple localized syringomas that was seen in our Dermatology department.

Brooke-Spiegler syndrome - report of four families: treatment with CO2 laser.

BACKGROUND: Brooke-Spiegler syndrome is a well known but rare cutaneous disorder characterized by the presence of multiple trichoepitheliomas and cylindromas. METHODS: Four families with Brooke-Spiegler syndrome are described. RESULTS: Spiradenomas developed on the back in two patients. A CO(2) laser was used to treat facial trichoepitheliomas in two patients with good results. CONCLUSIONS: The large number of facial lesions in this syndrome often produce a significant emotional impact. We believe that it is important to provide patients with a good therapeutic option. CO(2) laser therapy may fill this role.

Spiradenocarcinoma of the breast arising in a long-standing spiradenoma.

The embryologic origin of the breast is related to salivary and sweats glands. Thus, breast neoplasms may show differentiation toward these tissues, although this is a rare event in humans. We report the clinicopathologic and immunohistochemical features of a 57-year-old woman presenting with a spiradenoma that originated in breast tissue and became malignant 40 years later. Some histogenetic concepts relevant to this case are discussed, along with a brief review of this neoplasm.

Siringocistadenoma papilífero: relato de dois casos localizados no couro cabeludo / The syringocystodenoma papilliferum: two case relat in scalp

O siringocistadenoma papilífero é um infreqüente hamartoma das glândulas sudoríparas, usualmente no couro cabeludo ou face. Observamos um siringocistadenoma papilífero do couro cabeludo em dois pacientes. O diagnóstico foi baseado no exame histológico. Exérese cirúrgica completa foi realizada. Alguns aspectos desta condição são discutidos

Espiradenoma ecrino: revisión de cuatro casos / Ecrine spirodenoma: review of 4 cases

Se describen cuatro casas de pacientes portadores de espiradenoma ecrino, tratados en el Hospital José Joaquín Aguirre. Se analizan los aspectos clínicos e histopatológicos de cada uno de ellos. El espiradenoma ecrino es un tumor anexial benigno, poco frecuente. Generalmente se presenta como un nódulo doloroso, único, localizado en la cabeza o tronco. La histopatología se caracteriza por mostrar un tumor bien delimitado, constituido por una masa epitelial compuesta de lóbulos basofílicos en dermis e hipodermis. El tratamiento consiste en su extirpación quirúrgica