DOCSLIB.ORG

Tumours of the Pilosebaceous Unit

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Tumours of the Pilosebaceous Unit Downloaded from jcp.bmj.com on 29 February 2008 Skin adnexal neoplasms—part 1: An approach to tumours of the pilosebaceous unit K O Alsaad, N A Obaidat and D Ghazarian J. Clin. Pathol. 2007;60;129-144; originally published online 1 Aug 2006; doi:10.1136/jcp.2006.040337 Updated information and services can be found at: http://jcp.bmj.com/cgi/content/full/60/2/129 These include: References This article cites 75 articles, 4 of which can be accessed free at: http://jcp.bmj.com/cgi/content/full/60/2/129#BIBL Rapid responses You can respond to this article at: http://jcp.bmj.com/cgi/eletter-submit/60/2/129 Email alerting Receive free email alerts when new articles cite this article - sign up in the box at the service top right corner of the article Notes To order reprints of this article go to: http://journals.bmj.com/cgi/reprintform To subscribe to Journal of Clinical Pathology go to: http://journals.bmj.com/subscriptions/ Downloaded from jcp.bmj.com on 29 February 2008 129 REVIEW Skin adnexal neoplasms—part 1: An approach to tumours of the pilosebaceous unit K O Alsaad, N A Obaidat, D Ghazarian ................................................................................................................................... See linked review p145 J Clin Pathol 2007;60:129–144. doi: 10.1136/jcp.2006.040337 Skin adnexal neoplasms comprise a wide spectrum of benign NORMAL HISTOLOGY OF SKIN and malignant tumours that exhibit morphological APPENDAGES Skin appendages are derived from the ectoderm, differentiation towards one or more types of adnexal structures and start to develop early during the embryological found in normal skin. Most adnexal neoplasms are relatively life. During the fourth week of development, a uncommonly encountered in routine practice, and pathologists single-cell-thick ectoderm and underlying meso- derm begin to proliferate, and differentiate can recognise a limited number of frequently encountered towards various structures, including skin appen- tumours. In this review, the first of two, the normal histology of dages. These specialised skin structures are located the skin adnexal structures is reviewed, and the histological within the dermis, including the deep dermis, and features of selected but important benign and malignant focally within the subcutaneous fatty tissue. They are represented by three histologically distinct tumours and tumour-like lesions of pilosebaceous origin structures: (1) the pilosebaceous unit; (2) the discussed, with emphasis on the diagnostic approach and eccrine sweat glands; and (3) the apocrine glands. pitfalls in histological diagnosis. The distribution and arrangement of these appen- ............................................................................. dages vary from one part of the skin to another, but the overall general basic morphogenesis is maintained. The pilosebaceous units (hair follicle kin adnexal tumours (SAT) are a large and diverse group of benign and malignant and sebaceous glands) originate from the primary neoplasms, which exhibit morphological dif- epithelial germs in the epidermis, a collection of S deeply basophilic cells in the basal cell layer of the ferentiation towards one of the different types of adnexal epithelium present in normal skin: pilo- epidermis, protruding into the dermis and sur- sebaceous unit, eccrine and apocrine. SAT may rounded by an aggregate of mesenchymal cells. display more than one line of differentiation The hair follicle is a tubular invagination from the (hybrid/composite tumours), rendering precise epidermis, responsible for the formation of hair, a classification of these neoplasms difficult.1 The highly modified keratinised structure. Highly diagnosis of these mixed SAT relies on histological vascular connective tissue papillae, enclosed by evaluation, and they are usually classified accord- bulbous expansion (the hair bulb), are located in ing to the predominant morphological component. the reticular dermis or in the superficial subcuta- The histogenesis of mixed adnexal tumours is still neous fatty tissue, and form the lower portion of uncertain; however, the possibility of origin from a the hair follicle. The inner, mitotically active cells pluripotent stem cells is suggestive.2 lining the dermal papillae undergo keratinisation Most SAT are benign, and local complete to form the hair shaft and internal root sheath. surgical excision is curative. However, diagnosing Each hair shaft consists of an innermost medulla, some of these tumours has important implications, surrounded by a broad, highly keratinised cortical as they might be markers for syndromes associated layer, and an outermost thin layer of overlapping with internal malignancies, such as trichilemmo- keratin, the cuticle. The outer two epidermal cell mas in Cowden disease and sebaceous tumours in layers of hair bulb form the external root sheath, See end of article for Muir–Torre syndrome. A malignant counterpart of which consists of large, glycogen-rich (clear) cells authors’ affiliations and is separated from the surrounding dermal ........................ almost every SAT has been described. These tumours are rare, locally aggressive, and have the connective tissue by a thick glassy membrane Correspondence to: potential for nodal involvement and distant composed of homogenised fibrous tissue (fig 1). Dr D Ghazarian, metastasis, with a poor clinical outcome. Department of Laboratory Medicine and Therefore, establishing a diagnosis of malignancy Abbreviations: Pathobiology, University of in SAT is important for therapeutic and prognostic BCC, basal cell carcinoma; BEPs, basaloid Toronto and University purposes. Because pathologists may not frequently epidermal proliferations; BFH, basaloid follicular hamartoma; CEA, carcinoembryonic antigen; DTE, Health Network, Toronto encounter SAT, and owing to their different General Hospital, 200 desmoplastic trichoepithelioma; EMA, epithelial membrane Elizabeth Street, Toronto, derivation and broad histogenesis, diagnosing antigen; GCDEP-15, gross cystic disease fluid protein 15; Ontario, Canada M5G these tumours may be challenging even to an HAS, hidroacanthoma simplex; H&E, haematoxylin and 2M9; danny.ghazarian@ experienced pathologist. In this article, we review eosin; HMWK, high molecular weight keratin; IHC, uhn.on.ca the histological features of selected benign, malig- immunohistochemical; LMWK, low-molecular weight nant and tumour-like lesions of pilosebaceous cytokeratin; MFT, multiple familial trichoepithelioma; NSJ, Accepted 2 July 2006 nevus sebaceous of Jadassohn; PAS, periodic acid Schiff; Published Online First origin (box 1), with emphasis on the diagnostic PTC, proliferating trichilemmal cyst; SAT, Skin adnexal 1 August 2006 approach and morphological pitfalls in histological tumours; SCAP, syringocystadenoma papilliferum; SMA, ........................ evaluation. smooth muscle actin www.jclinpath.com Downloaded from jcp.bmj.com on 29 February 2008 130 Alsaad, Obaidat, Ghazarian Sebaceous glands are immunoreactive to low-molecular weight Box 1 Skin adnexal neoplasms and neoplastic-like cytokeratin (LMWK), epithelial membrane antigen (EMA) and, lesions of pilosebaceous origin to a lesser extent, to the lymphatic marker D2-40. They are negative for S100 protein and carcinoembryonic antigen (CEA). Hyperplastic and hamartomatous lesions Eccrine sweat glands originate from epidermal epithelial germs protruding into the dermis similar to those of pilosebac- N Hair and hair follicle eous units, but contain less mesenchymal condensation. They are distributed almost everywhere in the skin. The sweat- – Basaloid follicular hamartoma secreting coil glands are tubular and consist of two anatomical – Basaloid epidermal proliferation portions: – Overlying dermal mesenchymal lesions 1. The secretory coil, located in the deep dermis at the – Trichofolliculoma junction with the subcutaneous tissue and composed of – Sebaceous trichofolliculoma clear pyramidal cells, and darkly stained cells that are often – Folliculosebaceous cystic hamartoma difficult to identify on light microscopy. These cells express – Trichodiscoma/fibrofolliculoma the immunohistochemical stains LMWK, EMA, CEA and – Pilar sheath acanthoma S100 protein (basal layer only). A single outer, discontin- uous layer of myoepithelial cells resting on a well-defined N Sebaceous glands basement membrane is present, and can be highlighted by immunohistochemical (IHC) analysis for smooth muscle actin (SMA), p63 and calponin. – Sebaceous hyperplasia 2. The excretory part is composed of a straight intradermal – Nevus sebaceous of Jadassohn portion and an intraepidermal spiral portion (acrosyrin- Benign neoplasms gium), and consists of a double layer of small cuboidal cells with no underlying myoepithelial layer. The cells in this N Hair and hair follicle part may stain with high molecular weight keratin (HMWK) and cytokeratin (CK) 14. – Trichofolliculoma – Desmoplastic trichoepithelioma Apocrine glands are seen mainly in the axillae, groin, pubic and perineal regions. In contrast with eccrine glands, apocrine – Trichoblastoma glands develop from an upper bulge in hair follicles that are in – Trichoblastic fibroma the early bulbous peg stage. They have a coiled, tubular – Trichoadenoma excretory portion with widely dilated lumen, lined by cuboidal – Proliferating trichilemmal cyst/pilar tumour epithelial cells with eosinophilic cytoplasm and apical snouts – Trichilemmoma (representing decapitation secretion), and an outer discontin- uous layer of myoepithelial
Load more

Recommended publications
  • Malignant Hidradenoma: a Report of Two Cases and Review of the Literature
    ANTICANCER RESEARCH 26: 2217-2220 (2006) Malignant Hidradenoma: A Report of Two Cases and Review of the Literature I.E. LIAPAKIS1, D.P. KORKOLIS2, A. KOUTSOUMBI3, A. FIDA3, G. KOKKALIS1 and P.P. VASSILOPOULOS2 1Department of Plastic and Reconstructive Surgery, 2First Department of Surgical Oncology and 3Department of Surgical Pathology, Hellenic Anticancer Institute, "Saint Savvas" Hospital, Athens, Greece Abstract. Introduction: Malignant tumors of the sweat glands difficult (1). Clear cell hidradenoma is an extremely rare are very rare. Clear cell hidradenoma is a lesion with tumor with less than 50 cases reported (2, 3). histopathological features resembling those of eccrine poroma The cases of two patients, suffering from aggressive and eccrine spiradenoma. The biological behavior of the tumor dermal lesions invading the abdominal wall and the axillary is aggressive, with local recurrences reported in more than 50% region, are described here. Surgical resection and of the surgically-treated cases. Materials and Methods: Two histopathological examination ascertained the presence of patients are presented, the first with tumor in the right axillary malignant clear cell hidradenoma. In addition to these region, the second with a recurrent tumor of the abdominal cases, a review of the literature is also presented. wall. The first patient underwent wide excision with clear margins and axillary lymph node dissection and the second Case Reports patient underwent wide excision of the primary lesion and bilateral inguinal node dissection due to palpable nodes. Patient 1. Patient 1 was a 68-year-old Caucasian male who had Results: The patients had uneventful postoperative courses. No undergone excision of a rapidly growing, ulcerous lesion of the additional treatment was administered.
    [Show full text]
  • Malignant Eccrine Acrospiroma with Nodal and Bone Metastasis
    Case Report Malignant eccrine acrospiroma with nodal and bone metastasis Burhan Wani, Shiekh Aejaz Aziz, Mohmad Hussain Mir, Gull Mohammad Bhat, Abdul Rashid Lone Department of Medical Oncology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190011, Kashmir, India. Correspondence to: Dr. Burhan Wani, Department of Medical Oncology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190011, Kashmir, India. E-mail: [email protected] ABSTRACT Acrospiromas are cutaneous tumors of sweat duct differentiation. Although various eccrine sweat gland tumours including benign acrospiroma are widely reviewed, malignant acrospiroma is rarely reported. Clinically, they resemble other cutaneous lesions and the primary treatment is wide local excision with or without lymph node dissection. The efficacy of adjuvant chemotherapy and radiation therapy requires further investigation. Key words: Acrospiroma; metastasis; chemotherapy; radiotherapy INTRODUCTION right inguinal region. The swelling was firm in consistency and mildly tender. There was another mass 2 cm below Acrospiroma represents a group of benign ductal tumors this measuring 3 cm × 2 cm, firm in consistency, mobile, of the eccrine sweat glands that sometimes are connected non-tender with normal overlying skin, felt to be a lymph to the skin, ranging from solitary plaques to exophytic node clinically. papules or dermal nodules.[1] Malignant acrospiroma (Syn: malignant nodular/clear cell hidradenoma, malignant clear The patient was operated on and excision of the mass cell acrospiroma, clear cell eccrine carcinoma, primary along with inguinal nodal dissection. Pathology revealed mucoepidermoid cutaneous carcinoma) comprises a dermal appendage neoplasm (acrospiroma -- of hydra group of rare epidermal, juxta-epidermal, and dermal adenoma type), well-circumscribed, with mitotic figures ductal carcinomas that may coexist with their benign (< 2/hpf).
    [Show full text]
  • A 5 Year Histopathological Study of Skin Adnexal Tumors at a Tertiary Care Hospital
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 4 Ver. VII (Apr. 2015), PP 01-05 www.iosrjournals.org A 5 Year Histopathological Study of Skin Adnexal Tumors at a Tertiary Care Hospital Dr.Vani.D1, Dr.Ashwini.N.S2, Dr.Sandhya.M3, Dr.T.R.Dayananda4, Dr.Bharathi.M5 1,2,3,5, Department of Pathology, Mysore Medical College & Research Institute, Mysore, India 4, Department of Dermatology, BGS Apollo Hospital, Mysore, India Abstract: Introduction: Skin adnexal neoplasms are uncommon and are daunting diagnostic problems in view of the wide spectrum of lesions and their variants. Benign adnexal neoplasms are more common than malignant lesions. Aim: To study histopathology of skin adnexal neoplasms and to correlate with the clinical profile. Methodology: 51cases with a diagnosis of skin adnexal neoplasm over a 5 year period reported in the Department of Pathology, Mysore Medical College & Research Institute were included in the study. Histopathological examination was done on Haematoxylin& Eosin stained slides and corroborated with special stains wherever required. Results: Skin adnexal tumors were most common in the age group of 40 to 49 years (21.56%, 11/51). Male to female ratio was 1:1.68. The head and neck region was the most common site affected (64.70%, 33/51) with 39.21% (20/51) caseslocated on the face. 74.50% (38/51) cases were benign and 25.49% (13/51) cases were malignant. The sweat gland tumors formed the largest group involving 43.13% (22/51) cases followed by the hair follicle tumors 37.25% (19/51) followed by sebaceous gland tumors 19.60% (10/51).
    [Show full text]
  • Angiosarcomas
    Angiosarcomas recurrence after surgical excision and radiother- Elisa Cinotti, Franco Rongioletti apy. In one case, the accompanying dense infl am- matory infi ltrate was attributable to a superimposed Cutaneous angiosarcoma is a rare, aggressive infection by Pseudomonas aeruginosa . vascular sarcoma that occurs in three main differ- Pathology : It is characterized by the same ent clinical settings: classic cutaneous angiosar- atypical vessels of the classical angiosarcoma, coma arising in sun-damaged skin of elderly with the addition of a prominent infl ammatory patients, cutaneous angiosarcoma associated lymphoid infi ltrate between the vessels, obliterat- with chronic lymphedema, and post radiation ing some or most of the channels (Fig. 2 ). The angiosarcoma. Recent studies have shown that infi ltrate can be diffuse or can be organized in high-level amplifi cation of MYC oncogene seems lymphoid follicles with germinal centers scat- to be specifi c for radiation and lymphedema- tered within the diffuse lymphoid infi ltrate. associated angiosarcoma. A new histological Vessels are poorly circumscribed, irregularly variant has been named pseudolymphomatous dilated, and anastomosing, lined by prominent, cutaneous angiosarcoma. In general, cutaneous atypical endothelial cells (Fig. 3 , 4 ) that usually angiosarcoma carries a poor prognosis, associ- express CD31 (Fig. 5 ), CD34, and D2-40. Most ated with 5-year overall survival rates between 10 of the cells of the lymphoid infi ltrate express and 30 %. strong immunoreactivity for CD3, CD4, CD5, Pseudolymphomatous angiosarcomas and CD45 markers, whereas only scattered cells Synonyms: Angiosarcoma with prominent express CD8. Most of the lymphocytes of the lymphocytic infi ltrate. germinal centers are positive for CD20, CD21, Introduction: Pseudolymphomatous cutane- CD79a, and Bcl-6 whereas Bcl-2 can be detected ous angiosarcoma, described by Requena et al .
    [Show full text]
  • Spectrum of Skin Lesions Including Skin Adnexal Tumors in a North Indian Tertiary Care Hospital
    Original Research Article DOI: 10.18231/2581-3706.2019.0013 Spectrum of skin lesions including skin adnexal tumors in a North Indian tertiary care hospital Megha Bansal¹, Honey Bhasker Sharma2,*, Nikhilesh Kumar3, Monika Gupta4 1,2Assistant Professor, 3Professor and Head, 4Professor, Dept. of Pathology, 1-4T. S. Misra Medical College and Hospital, Amausi, Lucknow. Uttar Pradesh, India *Corresponding Author: Honey Bhasker Sharma Email: [email protected] Abstract Aims: This study was undertaken in a tertiary care hospital in North Indian state of Uttar Pradesh to evaluate the pattern of skin diseases and various skin neoplasms in biopsy specimens. Material and Methods: A retrospective analysis of 109 skin biopsies was undertaken. The neoplasms were categorised as per International Classification of World Health Organization. Results: Keratinous cyst (59 cases) was the most common non- neoplastic skin lesion and it represented 79.7% of non- neoplastic skin lesions. The most common neoplastic skin lesions were soft tissue tumors of vascular origin encompassing pyogenic granuloma which was 34.2% of skin tumors. Commonest malignant neoplasm was squamous cell carcinoma which is categorized under classification of keratinocytic tumors of skin. Conclusion: Histopathological examination is essential for the diagnosis and classification of various skin lesions including skin tumors which helps in proper treatment of the patient. Keywords: Dermatological, Keratinocytic, Follicular. Introduction Aims and objectives Dermatological disorders are very common. They may To retrospectively study the histopathological spectrum be intrinsic to the skin or may arise as manifestations of of skin lesions with special reference to skin tumors as systemic disease.1 Despite the advances in molecular prevalent in North Indian state of Uttar Pradesh.
    [Show full text]
  • ASCP. Cutaneous Adnexal Neoplasms: Classification and A
    1355 Cutaneous Adnexal Neoplasms: Classification And A Practical Diagnostic Approach David S. Cassarino, MD, PhD, FASCP WEEKEND OF PATHOLOGY AMERICAN SOCIETY FOR CLINICAL PATHOLOGY 33 W Monroe Ste 1600 Chicago, IL 60603 Program Content and Disclosure The primary purpose of this activity is educational and the comments, opinions, and/or recommendations expressed by the faculty or authors are their own and not those of the ASCP. There may be, on occasion, changes in faculty and program content. In order to ensure balance, independence, objectivity, and scientific rigor in all its educational activities, and in accordance with ACCME Standards, the ASCP requires all individuals in positions to influence and/or control the content of ASCP CME activities to disclose whether they do or do not have any relevant financial relationships with proprietary entities producing health care goods or services that are discussed in the CME activities, with the exemption of non-profit or government organizations and non-health care related companies. These relationships are reviewed and any identified conflicts of interest are resolved prior to the activity. Faculty are asked to use generic names in any discussion of therapeutic options, to base patient care recommendations on scientific evidence, and to base information regarding commercial products/services on scientific methods generally accepted by the medical community. All ASCP CME activities are evaluated by participants for the presence of any commercial bias and this input is utilized for subsequent CME planning decisions. The individuals below have responded that they have no relevant financial relationships with commercial interests to disclose: Course Faculty: David S.
    [Show full text]
  • Poroma : Article by Timothy Mccalmont, MD Page 1 of 8
    eMedicine - Poroma : Article by Timothy McCalmont, MD Page 1 of 8 Home | Specialties | Resource Centers | Learning Centers | CME | Contributor Recruitment March 16, 2007 nmlkji Articles nmlkj Images nmlkj CME Advanced Search Consumer Health Link to this site You are in: eMedicine Specialties > Dermatology > Benign Neoplasms Quick Find Author Information Rate this Article Introduction Poroma Clinical Email to a Colleague Differentials Last Updated: February 22, 2007 Workup Get CME/CE for article Treatment Synonyms and related keywords: poroma, apocrine poroma, juxtaepidermal poroma, juxta- Follow -up epidermal poroma, hidroacanthoma simplex, dermal duct tumor, adnexal neoplasm, adnexal tumor, Miscellaneous eccrine poroma, poromatosis, intraepidermal poroma, dermal poroma, poroid hidradenoma, Pictures acrospiroma Bibliography Click for related AUTHOR INFORMATION Section 1 of 10 images. Author Information Introduction Clinical Differentials Workup Treatment Follow -up Miscellaneous Pictures Bibliography Related Articles Author: Timothy McCalmont, MD , Director, UCSF Dermatopathology Service, Seborrheic Professor of Clinical Pathology and Dermatology, Departments of Pathology and Keratosis Dermatology, University of California at San Francisco Squamous Cell Timothy McCalmont, MD, is a member of the following medical societies: Alpha Carcinoma Omega Alpha , American Medical Association , American Society of Dermatopathology , California Medical Association , College of American Trichilemmoma Pathologists , and United States and Canadian Academy
    [Show full text]
  • Adnexa Cutis: Demystifying the Plethora of Pilosebaceous and Sweat Gland Neoplasms
    Original Research Article Adnexa Cutis: Demystifying the plethora of Pilosebaceous and Sweat gland neoplasms Deepak Kumar B1,*, Sakthidasan Chinnathambi P2, Srinivasa Murthy V3 1Associate Professor, 2Junior Resident, 3Professor & Head, Dept. of Pathology, ESIC Medical College & PGIMSR ESIC Model Hospital, Bangalore *Corresponding Author: Email: [email protected] Abstract Background: The neoplasms of the adnexa cutis arising from the pluripotent stem cell show differentiation towards one of the four adnexal cell lines i.e. follicular, sebaceous, eccrine and apocrine type. Categorizing these neoplasms into specific cell line differentiation and into benign or malignant is important, as malignant adnexal neoplasms are associated with a number of uncommon genetic syndromes and have an aggressive outcome. This study was conducted to primarily categorize these neoplasms based on their histological differentiation. Methods: Fifty-five cases of adnexa cutis that were reported over a four-year period were classified based on their histopathological differentiation and association with clinical parameters. Results: Thirty-three cases (60%) showed pilosebaceous differentiation with pilomatricoma being the commonest benign neoplasm. Twenty two cases (40%) showed eccrine differentiation. The most common malignant adnexal tumor was sebaceous carcinoma. (3 cases – 5.4%). Conclusion: All clinically suspected nodular/papular lesions should be subjected for histopathological examination and classified by differentiation to accurately determine the biologic behavior of the neoplasm. Key Words: Adnexa Cutis, Neoplasm. Access this article online internal malignancies. The histogenesis of these Quick Response neoplasms is attributed to a pluripotent stem cell resident Code: Website: in the epidermis with divergent differentiation into any www.innovativepublication.com of the four lines.3,4 These heterogenous and complex patterns can be histomorphologically demystified which enable diagnosis and prognostication in these patients.
    [Show full text]
  • Fine Needle Aspiration Cytology of Eccrine Skin Adnexal Tumors
    ytology & f C H i o s l t a o n l o r Devanand and Vadiraj, J Cytol Histol 2011, 2:6 g u y o J Journal of Cytology & Histology DOI: 10.4172/2157-7099.1000129 ISSN: 2157-7099 ReviewResearch Article Article OpenOpen Access Access Fine Needle Aspiration Cytology of Eccrine Skin Adnexal Tumors Devanand B1 and Vadiraj P2* 1Professor, VIMS Bellary, Karnataka, India 2Consultant Dermatologist, Bellary, Karnataka, India Abstract Background: Mastery of cytodiagnosis of adnexal tumors is challenging by virtue of the enormous number of individual tumors and their variant forms, the complicated nomenclature and the frequency of differentiation along two or more adnexal lines in the same tumor. Aim : The present study is undertaken to assess the application of fine needle aspiration cytology in the diagnosis of eccrine skin adnexal tumors at all possible dermal and subcutaneous sites. Material and Methods: This is a retrospective study of fine needle aspiration cytology of subcutaneous swellings over a period of two years from January 2009 to December 2010 in a tertiary care center. A total of 2400 cases of dermal and subcutaneous swellings, for which fine needle aspiration cytology was done with histological follow up, were included in the study. The aspirates were provisionally diagnosed as basaloid neoplasms of skin adnexal origin. The aspirates were further grouped into benign and malignant lesions based on cell morphology and correlation between cytological and histological diagnoses was assessed. Results: Out of the 2400 cases of subcutaneous swellings, 20 cases were provisionally diagnosed as basaloid neoplasms of skin adnexal origin. They included 12 benign and 8 malignant lesions.
    [Show full text]
  • Eccrine Acrospiroma of Eyelid with Malignant Transformation- a Case Report and Review of Literature
    CASE REPORT ECCRINE ACROSPIROMA OF EYELID WITH MALIGNANT TRANSFORMATION- A CASE REPORT AND REVIEW OF LITERATURE Sucheta Parija1,*, Bijnya Birajita Panda2 Assistant Professor, Senior Resident AIIMS, Bhubaneswar *Corresponding Author: Email: [email protected] ABSTRACT The aim of this article is to present a clinico-pathological case report of a sweat gland tumor of eyelid that rarely undergoes malignant transformation. A 60-year-old woman presented with a painful ulcerated nodule on her eyelid which was excised with wide margins under frozen section control. The mass was sent for histopathology and after confirming tumor free margins, lid reconstruction was done by procuring a glabellar flap. Routine histopathology was diagnostic of Eccrine Acrospiroma with malignant transformation. Metastatic work up in the patient was within normal limits. The glabellar flap was healthy and no recurrence noted at one year of follow-up. Key words: Eccrine Acrospiroma, frozen section, Sweat gland tumor INTRODUCTION physical examination was within normal limits with absence of any regional Eccrine Acrospiroma is an lymphadenopathy. A wide margin excisional uncommon benign sweat gland tumor of clearance was performed and sent for fairly characteristic histology which frozen section. After confirmation of tumor undergoes malignant transformation in 1.5 free margins, lid reconstruction was % of cases1. Though eccrine acospiromas planned. A forehead median rotational flap have a predilection for the lower extremity, was taken up for reconstruction of the they tend to occur on the extremities, medial canthal and lower lid defect. The trunk, head, and neck2. Eccrine Hematoxylin and Eosin stained picture Acrospiroma with malignant transformation showed structure of ulcerated tumor tissue in the eyelid is exceedingly rare with only 6 formed by two types of cells: dark cells at cases previously reported in the literature3- the periphery and pale cells in the central 8.
    [Show full text]
  • Nodular Hidradenoma: a Forgotten Tumor of the Scalp Shruthi Madhavi Govindarajulu*
    ISSN: 2469-5750 Govindarajulu. J Dermatol Res Ther 2021, 7:095 DOI: 10.23937/2469-5750/1510095 Volume 7 | Issue 1 Journal of Open Access Dermatology Research and Therapy CASE REPORT Nodular Hidradenoma: A Forgotten Tumor of the Scalp Shruthi Madhavi Govindarajulu* Check for Department of Dermatology Venereology and Leprosy, Sri Devaraj Urs Medical College, Kolar, Karnataka, India updates *Corresponding author: Shruthi Madhavi Govindarajulu, Department of Dermatology Venereology and Leprosy, Sri Devaraj Urs Medical College, Kolar, Karnataka, India A solitary, non-tender, firm to hard, mobile swelling of Abstract size 3 × 3 cm present, over the left post-auricular region. Hidradenoma or Eccrine acrospiromas are rare benign tu- The surface of the swelling was smooth with reddish dis- mours that arise from the eccrine sweat gland. Eccrine acro- spiromas are nonencapsulated, well-circumscribed, multi- colouration, numerous dilated blood vessels with few lobular dermal nodules that may involve the epidermis and areas of pus pointing (Figure 1). The surrounding area extend into the subcutaneous fat. A 30-year-old male pa- appeared normal with no regional lymphadenopathy. tient presented with an asymptomatic progressive swelling on the scalp of 6 months duration. Cutaneous examination: Excisional biopsy of the mass was done, where in it A solitary, non-tender, firm to hard, mobile swelling over the was removed in en masse with a 2 cm margin and was scalp. Dermoscopic examination: Revealed white and red sent for histopathological examination which revealed areas. Histopathological examination revealed tissue lined by epidermis with dermis showing tumor arranged in nodu- tissue lined by epidermis with dermis showing tumour lar configuration with proliferating cells with cells with clear arranged in nodular configuration with proliferating cells cytoplasm with focal areas of squamous metaplasia.
    [Show full text]
  • Hidradenoma Masquerading Digital Ganglion Cyst Makaram, Navnit; Chaudhry, Iskander H.; Srinivasan, Makaram S
    University of Dundee Hidradenoma masquerading digital ganglion cyst Makaram, Navnit; Chaudhry, Iskander H.; Srinivasan, Makaram S. Published in: Annals of Medicine and Surgery DOI: 10.1016/j.amsu.2016.07.017 Publication date: 2016 Licence: CC BY-NC-ND Document Version Publisher's PDF, also known as Version of record Link to publication in Discovery Research Portal Citation for published version (APA): Makaram, N., Chaudhry, I. H., & Srinivasan, M. S. (2016). Hidradenoma masquerading digital ganglion cyst: a rare phenomenon. Annals of Medicine and Surgery , 10, 22-26. https://doi.org/10.1016/j.amsu.2016.07.017 General rights Copyright and moral rights for the publications made accessible in Discovery Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from Discovery Research Portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain. • You may freely distribute the URL identifying the publication in the public portal. Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Download date: 27. Sep. 2021 Annals of Medicine and Surgery 10 (2016) 22e26 Contents lists available at ScienceDirect Annals of Medicine and Surgery journal homepage: www.annalsjournal.com Case report Hidradenoma masquerading digital ganglion cyst: A rare phenomenon * Navnit Makaram a, , Iskander H.
    [Show full text]