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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 one or several tumor nodules of variable shapes and sizes, frequently with tubular and ductal structures as well as mass necrosis. Although the overlying epithelium may be eroded or ulcerated there is no connection with the epidermis. The tumor proliferations are made up of pale to clear cells with a distinct cytoplasmic membrane, pleomorphic nuclei, and many mitoses. Nuclear atypia was described in the ungual hidradenocarcinoma. Benign clear-cell hidradenoma with focal degenerative changes has to be differentiated. Other differential diagnoses include other clear-cell tumors such as clear-cell Bowen’s carcinoma, but also rhabdoid and tumors with a granular cytoplasm.2
Epithelial and fibroepithelial tumors
Published in Eckart Haneke, Histopathology of the NailOnychopathology, 2017
Benign clear-cell hidradenoma with focal degenerative changes has to be differentiated. Other differential diagnoses depend on the cytologic criteria and include other clear-cell tumors such as clear-cell Bowen's carcinoma, but also tumors with rhabdoid cells and a granular cytoplasm.
Hidradenoma papilliferum of the perineum; a rare tumour in a rare location
Published in Journal of Obstetrics and Gynaecology, 2023
Saliha Sağnıç, Sinan Serdar Ay, Hasan Aykut Tuncer, Selen Doğan, Tayup Şimşek
A 23-year-old virgin woman with a 4–5 year history of itching and bleeding due to irritation of a 2 × 2 cm mass lesion on the perineum, was referred to our tertiary hospital due to suspicion of vulvar cancer. There was no change in size in the last 3 years. She stated no changes occurred during her menstrual period. Her past medical history was unremarkable. Clinical examination revealed a single well-circumscribed, skin-colored, smooth, non-ulcerated, non-tender polypoid mass lesion arising from the perineum (Figure 1). The rest of the gynecological examination was normal without any inguinal lymphadenopathy. Since our patient was a virgin, smear and human papillomavirus tests were not performed. We performed an excisional biopsy of the mass for diagnosis under local anaesthesia. Histopathological examination suggested the diagnosis of hidradenoma papilliferum. Immunohistochemical studies revealed CK 7 positivity in luminal cells and p63 positivity in the myoepithelial cells. The patient was discharged with no complaint following the procedure. Follow-up of the patient shows no actual recurrence. Written informed consent was obtained from the patient for publication of this case report and accompanying image. Ethics committee approval was unnecessary due to the nature of the study.
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].
Endocrine mucin-producing sweat gland carcinoma: a systematic review and meta-analysis
Published in Journal of Dermatological Treatment, 2022
Michael H. Froehlich, Keith R. Conti, Ivy I. Norris, Jordan J. Allensworth, Nicole A. Ufkes, Shaun A. Nguyen, Evelyn T. Bruner, Joel Cook, Terry A. Day
We believe the underreported incidence of EMPSGC can be attributed to numerous factors, including rarity of disease and inaccurate diagnosis due to its clinical and histologic resemblance to other cutaneous tumors (3,4). Additionally, nearly 70% of all documented cases have been published within the past four years. In the systematic review, of the 110 identified EMPSGCs tumors, the clinical differential diagnosis included 36 distinct clinical diagnoses and 22 distinct, non-EMPSGC pathological diagnoses were made. In the cohort, 45.5% of pathologically misdiagnosed tumors were incorrectly diagnosed as a hidradenoma, which is a far more common, benign cutaneous tumor than EMSPGC. As such, there are likely more EMPSGCs not reported due to incorrect pathological diagnoses of a lesion. For this reason, many patients with EMSPGCs may not receive appropriate workup and staging (Table 2). While cutaneous metastasis of primary carcinomas of the breast and gastrointestinal tract is rare, they also merit consideration when biopsied due to the histopathologic similarities EMPSGC shares with these types of primary tumors (4).