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Hidradenoma
Published in Longo Caterina, Diagnosing the Less Common Skin Tumors, 2019
Nodular hidradenoma, also called clear cell hidradenoma, eccrine acrospiroma, solid-cystic hidradenoma, clear cell myoepithelioma and eccrine sweat gland adenoma, is an uncommon benign adnexal neoplasm that is currently thought to be of apocrine origin, but in a minority of cases can also be eccrine (poroid hidradenoma).1 The different variants of hidradenoma cannot be distinguished on a clinical and dermoscopic basis, as in both cases they appear as well-circumscribed, slowly growing nodules with no body site predilection and are more frequently seen in middle-aged patients, with a slight prevalence in females.2 Histopathologically hidradenoma appears as nonencapsulated solitary dermal nodules that are 1–3 cm in diameter, which may be solid and cystic in different proportions; duct-like structures are also commonly present. Apocrine and eccrine hidradenomas may only be distinguished on histopathologic examination, since the latter are composed of poroid and cuticular cells; while, in the former, clear, polygonal and mucinous cells are present. Clear cells are rich in glycogen and predominate in one-third of cases. The stroma is usually sclerotic.1 The malignant variant, hidradenocarcinoma, is exceedingly rare and may originate in a preexisting hidradenoma. Because of the very aspecific clinical appearance, the differential diagnosis of hidradenoma includes many other benign and malignant skin tumors, in particular, nonmelanoma skin cancers.3
Malignant tumors
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Histopathology reveals multilobular aggregates of cuboid to low columnar basophilic cells with round to oval nuclei. Spaces are formed into which tumor cell proliferations protrude giving the appearance of a papillary lesion. A cribriform pattern is sometimes seen. A fibrovascular core may be seen in some areas whereas other projections lack stromal support. Although mitoses and necrotic areas are frequent there is little cytologic atypia. Cysts contain necrotic debris or eosinophilic material similar to secretory material. Tumors are well-circumscribed or show an infiltrative border. ADPAC is thought to derive from eccrine sweat glands65 and an important differential diagnosis is papillary eccrine adenoma. Other histologic differential diagnoses are eccrine acrospiroma, hidradenoma, chondroid syringoma, and, rarely, metastatic papillary adenocarcinoma of the breast, lung, thyroid, or ovary.66 No specific histologic features have been identified to predict recurrence or metastasis.59
Skin and soft tissue
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
They can be pigmented and thus resemble a melanoma. Actual malignant change (to a malignant eccrine acrospiroma) is rare but has been reported with propensity for local recurrence and distant metastasis. Excision is the commonest treatment.
Prognostic analysis of hidradenocarcinoma: a SEER-based observational study
Published in Annals of Medicine, 2022
Teng Gao, Sheng Pan, Meng Li, Runping Su
In 1954, Keasby and Hadley first reported that hidradenocarcinoma was believed to be an uncommon malignant transformation of nodular hidradenoma [1]. As an uncommon malignant transformation, hidradenocarcinoma was found in 1:13,000 skin biopsies, accounting for only 6% of malignant eccrine tumours [2,3]. The study by Kazakov et al. [4] showed that a hidradenoma remnant was found in 5 of 14 primary hidradenocarcinomas, and the transition to a cancerous component was clearly evident. Hidradenocarcinoma is also known as malignant clear cell hidradenoma, clear cell hidradenocarcinoma, and malignant acrospiroma [5,6]. The main clinical manifestations of hidradenocarcinoma are isolated, hard, asymptomatic intradermal erythematous, or violaceous nodules on the head, neck, trunk, limbs, or oral cavity [7]. The accepted histological criteria for diagnosing hidradenocarcinoma include lack of demarcation, invasive growth pattern, deep extension, nuclear pleomorphism, necrosis, vascular invasion, perineural invasion, and the presence of an increased number of mitoses [8–10]. Hidradenocarcinoma usually grows slowly for many years, but it may increase rapidly in the short term [11].
An unexpected tumour of the finger: review and management
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
N. Jumper, E. Caffrey, N. McInerney
Digital papillary adenocarcinoma (DPA), a cutaneous tumour thought to be of eccrine origin, was first described by Helwig in 1979 and published in 1984 as “eccrine acrospiroma” [1]. His contribution to the first case series, published by Kao et al in 1987, described two entities: aggressive digital papillary adenoma (ADPA) and adenocarcinoma (ADPAca), providing the first detailed clinicohistopathological reference for this neoplasm [2]. An updated retrospective analysis of this series, published with additional data in 2000 by Duke et al, determined none of the clinical or histologic parameters were predictive of biologic behaviour and therefore all tumours were to be considered potentially malignant, leading to one designation where the term ‘aggressive’ is omitted: digital papillary adenocarcinoma [3]. The often cystic and clinically indolent nature of DPA in addition to 85% of tumours occurring on the hands, of which 79% present on the fingers, frequently leads to misdiagnosis as a benign lesion [3]. The experience communicated in several case reports, as well as smaller case series, support the findings of these publications, demonstrating high rates of local recurrence (up to 50%) and metastasis (14–41%) [3]. Despite these accounts in the literature, the paucity of cases of this rare tumour leave definitive guidelines for management lacking. Here we report the case of presumed ganglion cyst or glomus tumour subsequently revealed to be a digital papillary adenocarcinoma on histopathology, thereby necessitating a review of the literature to determine the most appropriate intervention.
Nodular hidradenoma of the breast: A case report
Published in Alexandria Journal of Medicine, 2018
G.H. Ano-Edward, I.O. Amole, S.A. Adesina, O.A. Ajiboye, M.E. lasisi, R.K. Jooda
Nodular hidradenoma is an established entity as a skin adnexial tumour arising from the eccrine sweat glands.1 It is still a very rare benign skin adnexial lesion.2 Literature review as at 2011, reported only 25 cases of the tumour.1 Nodular hidradenoma is also known as clear cell hidradenoma, eccrine acrospiroma and solid cystic hidradenoma. The common locations include face, upper extremities, axilla, trunk, thigh, scalp and pubic region.3 Rarely, it has been reported in the breast at the nipple areolar region and is slightly more common in women than men.3 It often presents as a slow growing painless breast lump although, there are reported cases of pain, nipple discharge and ulceration of the overlying skin.4