DOCSLIB.ORG

Adnexal Tumors

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Adnexal Tumors 10/24/2019 What’s a gland like you doing in a place like this? A practical approach to cutaneous adnexal neoplasms Hafeez Diwan, MD, PhD Departments of Pathology & Immunology and Dermatology Baylor College of Medicine 1 Conflict of interest • None 2 Disclosures • I have nothing to disclose 3 1 10/24/2019 Is the adnexal neoplasm glandular? And if so, where is it located? • Hands and Feet: Digital papillary adenocarcinoma 4 5 6 2 10/24/2019 7 8 Digital Papillary Adenocarcinoma • Solitary • Fingers/toes/palms/soles • Recurrence/metastases 9 3 10/24/2019 10 11 12 4 10/24/2019 3 Points about digital papillary adenocarcinoma • 1. Atypia doesn’t matter – if there is no atypia, it doesn’t mean that it isn’t digital papillary adenocarcinoma 13 3 Points about digital papillary adenocarcinoma • 1. Atypia doesn’t matter – if there is no atypia, it doesn’t mean that it isn’t digital papillary adenocarcinoma • 2. How high can the glandular lesion go up the extremity? • Example of one case that occurred on the thigh? (Alomari A, Douglas S, Galan A, Narayan D, Ko C. Atypical Presentation of digital papillary adenocarcinoma (abstract) J Cutan Pathol. 2014;41:221) 14 3 Points about digital papillary adenocarcinoma (cont’d) • 3. What if you don’t see glands • Hidradenoma on hands and feet • Hunt for a gland? If you see a gland, then what? • Probably best to err on the side of caution and say that a digital papillary adenocarcinoma is not ruled out 15 5 10/24/2019 16 17 18 6 10/24/2019 19 20 21 7 10/24/2019 3 Points about digital papillary adenocarcinoma (cont’d) • 3. What if you don’t see glands • Hidradenoma on hands and feet • Hunt for a gland? If you see a gland, then what? • Probably best to err on the side of caution and say that a digital papillary adenocarcinoma is not ruled out • P63? • Positive in basal layer of digital papillary adenocarcinoma vs. throughout in hidradenoma? 22 Digital papillary adenocarcinoma – quasi- controversial aspects • Previously used to be called aggressive, till the “aggressive” was dropped • Now, some authors have suggested they may not be that aggressive (because a myoepithelial layer is present, so is it really adenocarcinoma in situ?) • However, as there is high potential for metastasis, with a local recurrence rate of 50% and a 14% rate of metastasis, most commonly to the lungs (70%), and since atypia is no guide to how these lesions will behave, it is probably best to call glandular adnexal neoplasms on hands and feet adenocarcinoma 23 Is it on or near the eyelid and does it have a cribriform appearance 24 8 10/24/2019 25 26 27 9 10/24/2019 Endocrine mucin-producing sweat gland carcinoma • EMPSGC is histologically and immunohistochemically similar to solid papillary carcinoma of breast/ endocrine ductal carcinoma in situ, which is considered a precursor lesion to mucinous carcinoma • EMPSGC is believed to be a precursor of cutaneous mucinous carcinoma (MC) 28 Histology • Cystic, partially cystic and/or solid tumor nests • Low-grade cytology • Neuroendocrine differentiation • Mucin production 29 Immunohistochemical studies • Expression of a specific neuroendocrine marker is required for the diagnosis of EMPSGC. Positive Staining Negative Staining ER CK20 PR CK7 LMWCK (CAM 5.2) CD56/synaptophysin/chromogranin Myoepithelial cells: SMA, p63, calponin (Discordant staining between authors) 30 10 10/24/2019 EMPSGC Mucin production is typically non- copious No infiltrative growth pattern Invasive mucinous carcinomas Nests and strands of cells infiltrating the dermis Advanced cases: clusters of tumor cells floating in large stromal pools of mucin 31 32 33 11 10/24/2019 Mucinous Eccrine Carcinoma • Face/scalp/axilla/trunk • Recurrence • Metastasis 34 Does it have a cribriform appearance and is well-circumscribed? Cutaneous Cribriform Carcinoma J-D Wu et al. Indian J Dermatol Venerol Leprol. 2018; 84(5):569-572: Neck of 26 year-old female 35 Cutaneous cribriform carcinoma • S100, C-kit positive; calponin, p63, SMA negative (helps distinguish from a tubular adenoma) – DP Arps et al. J Cutan Pathol. 2015; 42:379-387: • 6 cases (3 leg, 2 arm, 1 elbow) • 5/6 had lymphoid aggregates • All had desmoplastic stroma • Circumscribed (unlike adenoid cystic carcinoma ACC, which is also C-kit & S100 positive; but ACC is not circumscribed and is neurotropic) 36 12 10/24/2019 YG Xu et al. J Oncol. 2010 Apr 7. doi: 10.1155/2010/469049 Pathology Outlines (GA Tranesh); Photo: Dr. Mark Wick 37 38 Beware of adenoid cystic carcinoma on the lower portion of the face! • It could be salivary gland adenoid cystic carcinoma extending into the skin. 39 13 10/24/2019 Does it have prominent eosinophilic secretions? Cutaneous secretory carcinoma L Requena & O Sangueza. Cutaneous adnexal neoplasms. Springer, 2018 No particular anatomic site Positive for S100, EGFR, p63, calponin, SMA Negative for CEA, p53, Her-2 neu Positive for ETV6-NTRK3 (like breast secretory carcinoma) 40 L Requena & O Sangueza. Cutaneous adnexal neoplasms. Springer, 2018 41 Does it have squamous or squamoid appearing areas with ducts? 42 14 10/24/2019 van der Horst MPJ, Brenn T. Surgical Pathology 10: 383– 397, 2017 43 van der Horst MPJ, Brenn T. Surgical Pathology 10: 383– 397, 2017 44 van der Horst MPJ, Brenn T. Surgical Pathology 10: 383– 397, 2017 45 15 10/24/2019 Squamoid eccrine carcinoma • Head and neck of elderly males • Most common: face • High recurrence • Can metastasize (most often to lymph nodes, but elsewhere as well) • Complete excision and clinical follow-up 46 Does it remind you of a rabbit burrow? 47 48 16 10/24/2019 THE RABBIT BURROW 49 50 51 17 10/24/2019 52 53 54 18 10/24/2019 55 Syringocystadenoma Papilliferum • Scalp and forehead • Other sites possible • Associated with NS • Coexistent BCC also possible 56 Does it remind you of a maze 57 19 10/24/2019 58 59 60 20 10/24/2019 THE MAZE 61 62 63 21 10/24/2019 64 Hidradenoma papilliferum with lactational changes 65 Primary vs metastatic • Primary – p63, p40, CK15, calretinin, D2-40, CK5/6 • Primary – look for a benign component; if there is one, it might be primary • Caveats • Triple negative BCC and lung CA can be p63 positive • Calretinin will be positive in metastatic mesothelioma • Apocrine carcinoma is p63 negative 66 22 10/24/2019 Primary vs metastatic • What about clear cells as in hidradenocarcinoma? • Ducts will be EMA/CEA, tumor itself will be LMWK and S100 • Renal cell carcinoma can have clear cells – but PAX8, CD10, RCC can help • Thyroid carcinoma can have clear cells – but TG and TTF-1 can help 67 Sebaceous neoplasms – to mismatch or not to mismatch • High false positives • Do it if the lesions look cystic or “complicated” or if there is a keratoacanthoma with sebaceous differentiation, or • If there are multiple lesions • If there is a family history 68 69 23 10/24/2019 70 71 72 24 10/24/2019 Is it sebaceous or not? • EMA (also SCC, but not BCC) • Adipophilin • Factor 13a • AR (but BCC can be positive) • NOT USEFUL ONES: • BerEP4 (BCC and sebaceous) • Cam5.2 (BCC, SCC, and sebaceous) • CK7 (BCC, SCC, and sebaceous) 73 Danialan R, Mutyambizi K, Aung PP, Prieto VG, Ivan D. J Clin Pathol 2015;68: 992–1002. 74 75 25 10/24/2019 Tjarks et al., JCP 45: 1-7, 2018 Factor 13a clone AC-1A1 76 Tjarks et al., JCP 45: 1-7, 2018 Factor 13a clone AC- 1A1) 77 What about focal sebaceous differentiation? • If it looks like SCCIS, or BCC, or invasive SCC with focal sebaceous differentiation, then it is probably just focal sebaceous differentiation rather than a sebaceous neoplasm. 78 26 10/24/2019 It might be benign, if it weren’t malignant • Can you see the bottom of the lesion? • Can you see the entire lesion? • Is the border infiltrative? 79 • 80 year-old male with left arm lesion – 11/30/12 80 81 27 10/24/2019 82 83 84 28 10/24/2019 • 2 months later, 1/28/13, the lesion was re-excised 85 86 87 29 10/24/2019 88 89 90 30 10/24/2019 91 92 93 31 10/24/2019 94 P16 95 • 87 year-old, center forehead lesion, 8/17/2012 96 32 10/24/2019 97 98 99 33 10/24/2019 100 • Nearly a year and a half later, re-biopsy 101 102 34 10/24/2019 103 104 105 35 10/24/2019 106 What might help in distinguishing benign from malignant sebaceous neoplasms • P53, Ki-67 – both increased in sebaceous carcinoma 107 Related concept – what’s the architecture of the lesion? • Circumscribed or infiltrative? • Even if it doesn’t look too atypical, infiltrativeness trumps atypia 108 36 10/24/2019 109 110 111 37 10/24/2019 112 Is there cytologic atypia? • If the border is infiltrative, then lack of atypia doesn’t matter much • But cytologic atypia can be helpful 113 114 38 10/24/2019 115 116 117 39 10/24/2019 118 119 120 40 10/24/2019 121 122 123 41 10/24/2019 124 Porocarcinoma • Local recurrence • Metastasis – both regional and distant 125 126 42 10/24/2019 127 Eccrine Carcinoma • Rare • Scalp/extremities/trunk • Local recurrence 128 129 43 10/24/2019 130 131 132 44 10/24/2019 133 Malignant pilomatricoma 134 Trichoepithelioma vs. BCC vs. MAC vs syringoma 135 45 10/24/2019 136 137 138 46 10/24/2019 BCC vs. TE • Bcl2 – BCC (also desmoplastic TE); peripheral cells in TE • BerEP4 – BCC (also desmoplastic TE) • CK 20 – TE • CD34 – TE stroma • CD10 – TE stroma; CD10 – BCC tumor • AR – BCC – But some studies show AR in TE • ?p75 in BCC and desmoplastic TE 139 140 141 47 10/24/2019 142 143 CD34 144 48 10/24/2019 CK20 145 Desmoplastic Trichoepithelioma • Face • Solitary • Very important differential diagnosis 146 147 49 10/24/2019 148 149 150 50 10/24/2019 Syringoma • Multiple, lower eyelids and cheeks • Adolescent females • Clear cell variant in DM • More
Load more

Recommended publications
  • Atypical Compound Nevus Arising in Mature Cystic Ovarian Teratoma
    J Cutan Pathol 2005: 32: 71–123 Copyright # Blackwell Munksgaard 2005 Blackwell Munksgaard. Printed in Denmark Journal of Cutaneous Pathology Abstracts of the Papers Presented at the 41st Annual Meeting of The American Society of Dermatopathology Westin Copley Place Boston, Massachusetts, USA October 14–17, 2004 These abstracts were presented in oral or poster format at the 41st Annual Meeting of The American Society of Dermatopathology on October 14–17, 2004. They are listed on the following pages in alphabetical order by the first author’s last name. 71 Abstracts IN SITU HYBRIDIZATION IS A VALUABLE DIAGNOSTIC A 37-year-old woman with diagnosis of Sjogren’s syndrome (SS) TOOL IN CUTANEOUS DEEP FUNGAL INFECTIONS presented with asymptomatic non-palpable purpura of the lower J.J. Abbott1, K.L. Hamacher2,A.G.Bridges2 and I. Ahmed1,2 extremities. Biopsy of a purpuric macule revealed a perivascular Departments of Laboratory Medicine and Pathology1 and and focally nodular lymphocytic infiltrate with large numbers of Dermatology2, plasma cells, seemingly around eccrine glands. There was no vascu- litis. The histologic findings in the skin were strikingly similar to those Mayo Clinic and Mayo Foundation, Rochester, MN, USA of salivary, parotid, and other ‘‘secretory’’ glands affected in SS. The cutaneous manifestations of SS highlighted in textbooks include Dimorphic fungal infections (histoplasmosis, blastomycosis, coccidiomy- xerosis, annular erythema, small-vessel vasculitis, and pigmented cosis, and cryptococcosis) can occur in immunocompromised and purpura. This case illustrates that purpura in skin of patients with healthy individuals. Cutaneous involvement is often secondary and SS may be caused by a peri-eccrine plasma-rich infiltrate.
    [Show full text]
  • 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 Nodular Hidradenoma-Inguinal Region Clinically Masquerading As Squamous Cell Carcinoma: a Case Report
    International Journal of Research in Medical Sciences Vernekar S et al. Int J Res Med Sci. 2019 Jul;7(7):2848-2852 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20192933 Case Report Malignant nodular hidradenoma-inguinal region clinically masquerading as squamous cell carcinoma: a case report Sunita S. Vernekar, Priyadharshini Bargunam* Department of Pathology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India Received: 24 April 2019 Accepted: 05 June 2019 *Correspondence: Dr. Priyadharshini Bargunam, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Malignant Nodular hidradenoma is an extremely rare aggressive tumour originating from eccrine sweat glands with an incidence of <.001%. So far less than 80 cases have been reported in the literature. It’s known for its local recurrence (50%) and metastasis (60%) and hence early diagnosis and radical treatment is mandatory. But differentiating it from its benign counterparts and other skin tumour mimics is challenging, due to its histopathological similarity & lack of diagnostic immunomarkers. Authors report a case of 65-year-old female who presented with a short 4-month history of rapidly growing ulceroproliferative growth in the right inguinal region with bilateral inguinal node enlargement, associated with pain and discharge. Wedge biopsy of left inguinal lymph node showed malignant cutaneous adnexal tumour deposits, which after excision was typed as malignant nodular hidradenoma.
    [Show full text]
  • Sample Research Poster
    Surgical management and lymph node biopsy of rare malignant cutaneous adnexal carcinomas: a population-based analysis of 7591 patients Amrita Goyal MD, 1 Theodore Marghitu,2 Nikhil Goyal BS,3 Nathan Rubin MS,4 Krishnan Patel MD,6 Kavita Goyal MD,1 Daniel O’Leary MD,5 Kimberly Bohjanen MD, 1 Ian Maher MD 1 1Department of Dermatology, University of Minnesota, Minneapolis, MN 2University of Minnesota Medical School, Minneapolis, MN 3National Institutes of Health/National Cancer Institute, Bethesda, MD 4Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis MN 5Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN 6Department of Radiation Oncology, University of Minnesota, Minneapolis, MN Background Overall and Disease-Specific Survival Lymph Node Biopsy and Survival Cutaneous adnexal carcinomas comprise a group of Vital status* All Sweat Hidradenocarc Spiradenocarci Sclerosin Porocarcin Eccrine Sebaceous Lymph Nodes All adnexal tumors adnexal gland inoma noma g sweat oma adenocarci carcinoma Lymph Nodes Examined carcino duct noma Nodes not examined 6592 (91.9) rare cutaneous malignancies that are generally ma tumor Nodes examined 578 (8.1) (MAC) Positive (% of examined) 138 (23.9) considered non-aggressive. Guidelines for the Stage (Derived AJCC N=1863 N=70 N=127 N=46 N=236 N=229 N=187 N=968 Negative (% of examined) 440 (76.1) Stage Group, 6th ed treatment of many of these malignancies are sparse, (2004-2015) Total N=1221 5-year OS 5-year DSS 1,2 I 1221 40 (57.1) 56 (44.1) 14 (30.4) 150 140 (61.1) 103 (55.1) 718 (74.2) Stage I Examined N=112 including guidance on surgical management (65.5) (63.6) Nodes not examined (% of total) 1109 (90.8) 69.7 (66.1-72.4) 99.3 (99.6-100) 3,4 II 440 14 (20.0) 54 (47.5) 28 (60.9) 47 (19.9) 64 (27.9) 51 (27.3) 182 (18.8) Nodes positive (% of examined) 0 (0) -- -- including the utility of lymph node biopsy.
    [Show full text]
  • University of Dundee Hidradenoma Masquerading Digital
    CORE Metadata, citation and similar papers at core.ac.uk Provided by University of Dundee Online Publications 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 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. DOI: 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: 17. Feb. 2017 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]
  • 第32回日本皮膚病理組織学会学術大会 診断投票結果 口演 1 Drug Eruption 13, うち Erythema Multif
    第３２回日本皮膚病理組織学会学術大会 診断投票結果 口演 1 Drug eruption 13, うち erythema multiforme 1, Interface dermatitis 1, GVHD type 1 Cutaneous reaction due to CCR4 3, うち Dysplastic epidermal hyperplasia 2, Adverse reaction 1 Erythema multiforme 3 PLEVA 1 Vacuolar type interface dermatitis 1 口演 2 Syringofibroadenoma 15, うち + amyloid 1 Syringofibroadenoma with BCC 5 Basal cell carcinoma 4, うち Pinkus type of BCC with syringofibroadenoma 2 口演 3 Darier disease 5 Hailey-Hailey disease 4 Pemphigus 3, うち Pemphigus Vegetans 1, Neonatal pemphigus 1 Grover's disease 4 Epidermal nevus 5, うち Acantholytic (dyskeratotic) epidermal nevus 4, Linear epidermal nevus 1 口演 4 Hydradenoma 13, うち Clear cell hidradenoma 12, Nodular hidradenoma 1 Sebaceous adenoma 1 Trichilemmoma 1 Metastatic tumor 8, うち ～ renal carcinoma6, ～ Clear cell carcinoma 2 口演 5 Apocrine carcinoma 3, うち ～with pagetoid spreading 2 Ectopic breast carcinoma(invasive ductal type)with pagetoid phenomenon 2 Extramammary Paget's disease 12, うち Paget carcinoma 3, ～ with Apocrine adenoma 2, ～ with Tubular adenoma 1, Invasive ～ 1, +Skin metastasis 1, With syringoma 1, with Microcystic Adnexal Carcinoma 1 Syringomatous carcinoma 2, うち ～with paget phenomenon 1 Tubular adenocartinoma 1 Tubular (apocrine) adenoma 2 Syringoma 1 口演 6 Dermatofibroma 10, うち Lipidized ～ 3, Hemosiderotic deep cellular ～ 2, Xanthomatous ～ 1, ～ Histiocytoid variant 1 Fibous histiocytoma 8, うち Atypical ～ 3, Malignant ～ 2, Aneurismal ～ 2 Undifferentiated pleomorphic sarcoma 2 Progressive nodular histiocytosis 1 Squamous
    [Show full text]
  • Eyelid Conjunctival Tumors
    EYELID &CONJUNCTIVAL TUMORS PHOTOGRAPHIC ATLAS Dr. Olivier Galatoire Dr. Christine Levy-Gabriel Dr. Mathieu Zmuda EYELID & CONJUNCTIVAL TUMORS 4 EYELID & CONJUNCTIVAL TUMORS Dear readers, All rights of translation, adaptation, or reproduction by any means are reserved in all countries. The reproduction or representation, in whole or in part and by any means, of any of the pages published in the present book without the prior written consent of the publisher, is prohibited and illegal and would constitute an infringement. Only reproductions strictly reserved for the private use of the copier and not intended for collective use, and short analyses and quotations justified by the illustrative or scientific nature of the work in which they are incorporated, are authorized (Law of March 11, 1957 art. 40 and 41 and Criminal Code art. 425). EYELID & CONJUNCTIVAL TUMORS EYELID & CONJUNCTIVAL TUMORS 5 6 EYELID & CONJUNCTIVAL TUMORS Foreword Dr. Serge Morax I am honored to introduce this Photographic Atlas of palpebral and conjunctival tumors,which is the culmination of the close collaboration between Drs. Olivier Galatoire and Mathieu Zmuda of the A. de Rothschild Ophthalmological Foundation and Dr. Christine Levy-Gabriel of the Curie Institute. The subject is now of unquestionable importance and evidently of great interest to Ophthalmologists, whether they are orbital- palpebral specialists or not. Indeed, errors or delays in the diagnosis of tumor pathologies are relatively common and the consequences can be serious in the case of malignant tumors, especially carcinomas. Swift diagnosis and anatomopathological confirmation will lead to a treatment, discussed in multidisciplinary team meetings, ranging from surgery to radiotherapy.
    [Show full text]
  • A Clinico-Histopathological Study of Cutaneous Appendageal Tumours
    IP Indian Journal of Clinical and Experimental Dermatology 5 (2019) 206–210 Content available at: iponlinejournal.com IP Indian Journal of Clinical and Experimental Dermatology Journal homepage: www.innovativepublication.com Original Research Article A clinico-histopathological study of cutaneous appendageal tumours Gowda Monika M1, S Sathish K1, M Basavarajaiah D2,* 1Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India 2Dept. of Dermatology, KVAFSU B Hebbal, Bidar, Karnataka, India ARTICLEINFO ABSTRACT Article history: The cutaneous appendageal tumors are an ideal subject for study from clinical and morphological point Received 01-08-2019 of view and so ubiquitous that they can affect people of all age group A histopathological study of 100 Accepted 13-08-2019 cases of cutaneous appendageal tumors was carried out at tertiary care hospital over 18 months. A Total Available online 14-09-2019 95 cases were benign and 5 cases were malignant tumors, constituting 95.0 % p<0.01 and 5.0 % p>0.01 respectively. Sweat gland tumors were the most common manifestation (79.0% ) p<0.01, followed by hair follicle tumors (20%) and eccrine duct tumors 1(1%). Male and female ratio was 27:73. The commonest Keywords: affected body site was head and neck region . The mean age was 36.58 1.22 years . Out of 95 cases cutaneous appendageal tumors of benign tumors, syringoma accounted for 48% (48), trichoepithelioma12 p<0.01, eccrine hydrocystoma malignant (11) p<0.01 ,trichofolliculoma, Apocrine hydrocystoma and nodular hidradenomaeach (4)p>0.01. Total histopathologically (39) p<0.01 are correlating both clinically and histopathologically and (61) p<0.01 are not correlating clinically clinically and histopathologically.
    [Show full text]
  • Brooke-Spiegler Syndrome – an Underrecognized Cause of Multiple Familial Scalp Tumors: Report of a New Germline Mutation
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Repositório Institucional dos Hospitais da Universidade de Coimbra 67 DOI: http://dx.doi.org/10.3315/jdcr.2015.1208 Brooke-Spiegler Syndrome – an underrecognized cause of multiple familial scalp tumors: report of a new germline mutation André Castro Pinho, Miguel José Pinto Gouveia, Ana Rita Portelinha Gameiro, José Carlos Pereira Silva Cardoso, Maria Margaria Martins Gonçalo Dermatology Department of Centro Hospitalar e Universitário de Coimbra, Portugal. Corresponding author: Abstract André Castro Pinho, MD Background: Brooke-Spiegler syndrome (BSS) is probably an underdiagnosed ge- Dermatology Department nodermatosis that predisposes for the development of cylindromas, spiradeno- mas and trichoepitheliomas mainly of the head and neck. Wide phenotypic varia- Hospitais da Universidade de Coimbra bility regarding the number and type of lesions can be observed within a family. Centro Hospitalar e Universitário Mutations of the CYLD gene are identified in the vast majority of cases and play de Coimbra a key role in BSS pathogenesis. Praceta Mota Pinto, 3000-075 Coimbra, Main observations: Two first degree relatives with numerous erythematous te- Portugal langiectatic nodules of the scalp present for decades, with recurring tendency re- gardless the multiple previous excisions. Histopathological review of the lesions E-mail: [email protected] revealed predominantly "spiradenocylindromas" in the proband and cylindromas in her sister. The suspicion of BSS was confirmed after detection of a new non- sense germline mutation of CYLD (c.1783C>T pGln 595*) in the proband. Conclusions: BSS diagnosis can be challenging and is based on clinical-patholo- gical correlation, positive familial association and identification of CYLD mutations.
    [Show full text]
  • Dermatopathology
    Dermatopathology Clay Cockerell • Martin C. Mihm Jr. • Brian J. Hall Cary Chisholm • Chad Jessup • Margaret Merola With contributions from: Jerad M. Gardner • Talley Whang Dermatopathology Clinicopathological Correlations Clay Cockerell Cary Chisholm Department of Dermatology Department of Pathology and Dermatopathology University of Texas Southwestern Medical Center Central Texas Pathology Laboratory Dallas , TX Waco , TX USA USA Martin C. Mihm Jr. Chad Jessup Department of Dermatology Department of Dermatology Brigham and Women’s Hospital Tufts Medical Center Boston , MA Boston , MA USA USA Brian J. Hall Margaret Merola Department of Dermatology Department of Pathology University of Texas Southwestern Medical Center Brigham and Women’s Hospital Dallas , TX Boston , MA USA USA With contributions from: Jerad M. Gardner Talley Whang Department of Pathology and Dermatology Harvard Vanguard Medical Associates University of Arkansas for Medical Sciences Boston, MA Little Rock, AR USA USA ISBN 978-1-4471-5447-1 ISBN 978-1-4471-5448-8 (eBook) DOI 10.1007/978-1-4471-5448-8 Springer London Heidelberg New York Dordrecht Library of Congress Control Number: 2013956345 © Springer-Verlag London 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work.
    [Show full text]
  • Pilomatricoma: a Case Report
    Open Access Austin Journal of Dermatology Case Report Pilomatricoma: A Case Report Jayakar Thomas*, Tamilarasi S, Asha D and Zohra Begum C Abstract Department of Dermatology, Sree Balaji Medical College Pilomatricoma is a benign tumor that arises from hair follicle matrical cells. & Bharath University, India Involvement of the upper limb is relatively uncommon and can be mistaken for *Corresponding author: Jayakar Thomas, other soft tissue tumors. We report the case of a 12 year old boy, who presented Department of Dermatology, Sree Balaji Medical College with an asymptomatic firm nodule over the left arm whose histology was & Bharath University, Chennai 600044, India, Email: suggestive of Pilomatricoma. [email protected] Keywords: Pilomatricoma; Shadow cells; Ghost cells; Basaloid cells Received: April 05, 2015; Accepted: May 29, 2015; Published: June 02, 2015 Introduction 1). The neurovascular status of the left hand was noted to be intact; there were no other palpable masses in the extremities and no axillary Pilomatricoma also known as Pilomatrixoma or calcifying adenopathy was present. Excision biopsy was performed under epithelioma of Malherbe is a benign neoplasm, which is derived regional anesthesia. Grossly the tumor was white in appearance and from hair follicle matrix cells. These tumors are typically present well circumscribed. in the head and neck region, but also occur in the upper limbs and are rarely reported in other sites[1].Pilomatricoma represents as an Histopathology revealed a capsulated benign neoplasm over asymptomatic, solitary, firm to hard, freely mobile nodule of the the subcutis, composed of lobules ofirregularly shaped masses of dermis or subcutaneous tissue. These tumors are generally exhibits ghost or shadow cells, scattered basophilic cells that undergo abrupt no fixation to neighbouring tissues and have an osseous- or cartilage- keratinization forming ghost [shadow] cells and areas of calcification.
    [Show full text]
  • Giant Proliferating Pilomatricoma and Superficial Angiomatous Proliferation: Case Report and Review of the Literature
    Yu K, et al., J Clin Dermatol Ther 2020, 6: 042 DOI: 10.24966/CDT-8771/100042 HSOA Journal of Clinical Dermatology and Therapy Case Report angiomyxoma has rarely been reported to be associated with pilo- Giant Proliferating Pilomatricoma matricoma. In the current report, we describe a case of a giant pro- liferating pilomatricoma associated with superficial angiomatous and Superficial Angiomatous proliferation. This tumor was unusually large and the rapid growth raised clinical suspicion of malignancy. The pathogenesis of such an Proliferation: Case Report and association will be discussed in this report. Review of the Literature Case Presentation A 83 year-old woman presented with an enlarging mass on the Kate Yu1, Natasha Singh1, Amin Maghari2 and Yong Kang2* thoracic area of her back. The mass was noted several years prior and 1Department of Pathology, Robert Wood Johnson Banarbas Health/Saint slowly growing since. Recent rapid growth raised clinical suspicion Banarbas Medical Center, Livingston, New Jersey, USA of malignancy. The physical examination revealed a 13 x 10 cm firm, exophytic, and reddish-brown mass with overlying bullous skin in 2 Department of Pathology, Robert Wood Johnson Banarbas Health/Mon- posterior thorax (Figure 1). She denied any prior surgery or trauma mouth Medical Center, Long Branch, New Jersey, USA to the affected area. There was no family history of similar lesions or known genetic syndromes. Macroscopic examination showed a well-circumscribed, nodular, dull white mass, measuring 12 x 9 x Abstract 4.7 cm. Sectioning of the mass found significant ossification of the involved tissue. Microscopic examination revealed a mutilobular pro- Giant proliferating pilomatricoma is a rare variant of pilomatrico- ma.
    [Show full text]