Poroid hidradenoma: a light microscopic and immunohistochemical study

Poroid hidradenoma is a recently described variant of the eccrine poroma group of tumors. This neoplasm shows architectural characteristics of hidradenoma (tumor cells confined entirely within the dermis in both solid and cystic components) and cytologic characteristics of poroid neoplasm (poroid and cuticular cells, the latter showing ductal differentiation). Therefore the term "poroid hidradenoma" seems to be the most appropriate. We document herein a case of poroid hidradenoma studied by immunoperoxidase techniques. Our immunohistochemical results are similar to those of other poroid neoplasms. These also support the inclusion of this tumor as the fourth variant within the eccrine poroma group of tumors.

Eccrine syringofibroadenomatosis: a clinical and histologic study and review of the literature

A 56-year-old man had an 11-year history of a psoriasiform eruption of the palms, soles, and shins. An examination revealed well-demarcated patches and plaques of erythematous, fissured, and hyperkeratotic skin with focal erosions. There was no clinical evidence of ectodermal dysplasia. On histologic examination these lesions proved to be eccrine hamartomas that consisted of anastomosing cords and strands of cuboidal epithelial cells with well-formed ducts and a fibrovascular mucinous stroma. Eccrine ductal origin was indicated by histopathologic, histochemical, immunopathologic, and electron microscopic evaluation. These multiple palmoplantar eccrine hamartomas, unassociated with ectodermal dysplasia, represent a sporadic hamartomatous condition that is best designated as "eccrine syringofibroadenomatosis."

Mucinous syringometaplasia mimicked by a clear cell hidradenoma with mucinous change

An adnexal tumor with features of both clear cell hidradenoma and mucinous syringometaplasia is reported. The lesion occurred as a solitary, asymptomatic, slow growing nodule of 6-months duration on the anterior neck of a 55-year-old woman. Serous fluid could be expressed from a central skin opening. Histologically, there was a squamous-lined invagination with foci of mucin-laden cells. A ductal component with a variable admixture of mucinous cells merged with a nearby clear cell hidradenoma. Because clinicopathologic similarities exist between mucinous syringometaplasia and clear cell hidradenoma with mucinous change, thorough sectioning of mucinous syringometaplasia-like lesions is necessary to exclude an associated sweat gland neoplasm.

Eccrine syringofibroadenoma: a report of 2 cases

Eccrine syringofibroadenoma is a rare benign tumor of the skin arising from the acrosyringeal portion of the eccrine duct. The tumor was first described by Mascaro in 1963, and since then only 8 case reports in 6 publications have been documented. This lesion is likely to be misdiagnosed both clinically and histologically due both to its rarity and its similarity to other more aggressive skin tumors. This report of 2 cases is presented to highlight the salient pathologic and clinical features of the tumor and to describe the long term follow up of 2 patients in whom the lesions have been electively reviewed rather than excised.

Eccrine spiradenoma occurring in infancy mimicking mesenchymal tumor

Eccrine spiradenoma (ES) rarely (less than 1%) occurs in infancy. These tumors differ from the conventional ES by the presence of superficial dermal nodules which display a less distinct two-cell pattern of immature adnexal epithelial cells and rarely ductule formation. These tumors may be mistaken for mesenchymal neoplasms involving the skin and subcutis of infants and young adults. Recognition of the histopathologic features and immunostains are required to make a definite diagnosis. We describe 2 cases of ES occurring in patients younger than one year. Detailed histopathologic and histochemical differential features of these tumors and mesenchymal neoplasms of the skin and subcutis commonly occurring in infants and young adults are discussed. The biologic behavior of infantile ES is benign, but complete excision is recommended to prevent recurrence. We speculate that these tumors may represent congenital hamartomatous growths.

Generalised eruptive syringoma--a papular dermatosis

Generalized eruptive syringoma is a rare condition characterised by multiple papules over the anterior trunk, sometimes extending on to the flexural aspects of the arms and thighs. A 22 year old Ethiopian woman with this disorder is presented.

Chondroid syringoma-scalp. A case report

A case of chondroid syringoma of scalp is reported. The case is of particular interest because of repeated recurrence with bone and dural infiltration.

Chondroid syringoma. A review of the literature and case report

The third documented case of chondroid syringoma occurring in a toe, involving the largest tumor of the three, along with a review of the literature, has been presented. The possibility of a mixed tumor should be kept in mind when considering the differential diagnosis of a solid nodule in the skin, particularly if it is of long duration. These tumors usually will present as simple, asymptomatic, subcutaneous nodules that are shelled out easily during surgical excision. However, there is a tendency toward local recurrence that usually is attributed to incomplete surgical removal, which easily may occur because of the lobulation of the tumor. Complete excision of the primary tumor always is recommended, as diagnosis can be made only by histopathologic examination. Six reported cases revealed that the recurrence of the lesion following primary excision resulted in malignant degeneration. In nine reported cases where metastasis had occurred, the initial site of metastasis in five patients was the regional lymph nodes, and, in four patients, there was metastasis in the lung. The period of time between the removal of the primary lesion and the malignant local recurrence or metastasis has been reported to be from 1 to 4 years. Recognition of chondroid syringoma is clinically difficult because of its rarity. Its diagnosis requires histologic examination.

Congenital spiradenoma

A case of an adenomatous sweat gland hamartoma present since birth is described. The histological and ultrastructural findings were similar to those of spiradenoma, and carcinoembryonic antigen, usually present in cutaneous sweat gland tumors, was also demonstrated. Sweat gland nevi are rare, and a spiradenomatous variant has not been previously documented.

Cystic papillary hidradenoma of the vulva: case report and review of the literature

Papillary hidradenoma of the vulva is a rare, benign neoplasm arising from apocrine sweat glands of the skin. Frequently, this lesion has been mistaken for carcinoma. The treatment of choice is local excision. The prognosis for patients with this tumor is excellent. We present a patient who is unique because she had a lesion which was the largest ever recorded, and which existed over twice as long as any previously described. This case is also presented to remind the clinician that, despite the gross appearance of the tumor which resembles carcinoma on sectioning, biopsy and histological diagnosis should guide the ultimate management of patients with such lesions. The findings in our patient support the view that no matter how large or how long in existence, hidradenoma remains benign.

Eccrine spiradenoma of eyelid: case report

A case report is presented of eccrine spiradenoma, a benign sweat gland tumour which, though not uncommon generally, is rare in the eyelid. The possibility of sweat gland tumour should be kept in mind in the diagnosis of eyelid tumours.

Syringadenocarcinoma papilliferum

A giant tumor developed on the right chest wall of a 52-year-old housewife over a 20-year period. It was accompanied by a spider-like invasion of skin, and a lymph node was palpated in the right axilla. Wide excision of the lesion was carried out. The cross-section of the tumor showed two different appearances. The tumor was histologically diagnosed as a syringadenocarcinoma papilliferum. The post-operative course was uncomplicated and without evidence of recurrence.

Epidermoid hidradenoma. A clinicopathologic study

Clinical and histopathologic data in 8 cases of epidermoid hidradenoma are presented. Most of the tumors were in the head and neck, and most of the patients were middle-aged and older adults. Generally, the lesions were asymptomatic nodules that sometimes showed ulceration or rapid growth. Despite having some histologic atypia or focal mitotic activity, the tumors were found to be benign on long-term evaluation. This epidermoid variant should not be otherwise differentiated from the benign group of solid-cystic hydradenomas, because cytologic variability did not predict a significant change in prognosis.

Syringocystadenoma papilliferum of the eyelid

Two patients presented with slowly developing papillated or hyperkeratotic lesions of their lid margins that began early in the fourth decade. Upon excision, these tumors were discovered to be examples of syringocystadenoma papilliferum, a lesion not previously well documented in the ophthalmic literature. By light microscopy, each tumor displayed surface poral openings where the epidermis underwent a transition into duct-like epithelium, which ramified as luminal channels throughout the tumor. Papillae projected into many of the duct-like spaces and were lined by columnar to multilaminar nonkeratinizing epithelium. A plasma cell-rich infiltrate was present in the connective tissue cores of the papillae. Electron microscopy performed on one of the lesions revealed that the channels were true ducts, with the innermost cells displaying microvilli, small numbers of tonofilaments, and apical junctional complexes composed of a zonula occludens and zonular adherens. These findings, coupled with the location of the tumors at the lid margin and the presence of dilated apocrine glands of Moll deep to one of the tumors, support an apocrine origin. The clinical differential diagnosis of syringocystadenoma papilliferum with respect to other more common lid tumors is discussed.

Proliferating trichilemmal cyst: a simulant of squamous cell carcinoma

Comparison of 50 proliferating trichilemmal cysts with 50 "ordinary" trichilemmal cysts indicated that both types almost invariably occurred on the scalps of women, were diagnosed clinically as cysts, followed a benign course, and featured trichilemmal keratinization. A spectrum was observed from trichilemmal cyst with minimal hyperplasia, to full-blown proliferating trichilemmal cyst. Occasionally, patients had ordinary trichilemmal cysts on their scalps associated with a proliferating trichilemmal cyst. In addition to trichilemmal keratinization, which is characteristic of the follicular isthmus, proliferating trichilemmal cysts showed a wider range of differentiation, including features of the follicular infundibulum, the lower nonkeratinizing portion of the follicular outer root sheath, and sebaceous cells. Intense inflammatory infiltrate and cellular atypia, sometimes of significant proportions, were also seen in proliferating trichilemmal cysts. It is concluded that trauma and inflammation may induce a trichilemmal cyst to proliferate and show a broader spectrum of pilosebaceous differentiation and cellular atypia of pseudocarcinomatous proportions, while maintaining its benign biologic behavior.

[Naevus sebaceus Jadassohn and syringocystadenoma papilliferum. Epithelial hamartoma of the skin]

Harmartomas are tumor-like local deformations of tissue-parts. Thus tumors of epidermal appendages must be classified in this sense. Until now these deformations were also called "organoid nevus". In the present paper we report studies on the nevus sebaceus of Jadassohn and the syringocystadenoma papilliferum, especially with regard to the coincidence with other dermoepidermal changes. From 1955 to 1979 a total of 164 histological specimens were diagnosed as nevus sebaceus Jadassohn (NSJ) or syringocystadenoma papilliferum (SCAP) in the department of dermatology, University Hospital Hamburg. 134 were NSJ, 11 were SCAP and 19 were combinations of both tumors. The percentage of multiple deformations of all 164 organoid nevi were 24.