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Laababsi R, Elkrimi Z, Bouzbouz A, Lekhbal A, Rouadi S, Abada R, Roubal M, Mahtar M. Hidradenoma papilliferum of the external auditory canal. Case report. Ann Med Surg (Lond) 2020; 49:41-43. [PMID: 31871682 PMCID: PMC6911944 DOI: 10.1016/j.amsu.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Hidradenoma papilliferum, also known as papillary hidradenoma, is a rare tumor of the sudoral glands, that occurs almost exclusively in women, on the vulvar and perineal region. Non-genital papillary hydradenoma is an even more rare occurrence, though some cases have been described in literature.This is a report of a 56 years old patient who presented with unilateral hearing loss secondary to a mass of the external auditory canal (EAC). A biopsy allowed us to make the diagnosis of a papillary hidradenoma of the EAC. The treatment was based on surgery; the tumor was removed while respecting the adjacent structures. Follow-up of the patient shows no actual recurrence. CONCLUSION Ectopic Hidradenoma papilliferum located in the EAC is a rare occurrence, and should be considered as a possible diagnosis when investigating a mass of the EAC.
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Affiliation(s)
- Rabii Laababsi
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco
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Theodosiou G, Zafeiriadou V, Papageorgiou M, Mandekou-Lefaki I. An unusual lesion in the right place. Dermatol Pract Concept 2016; 6:7-9. [PMID: 27648377 PMCID: PMC5006546 DOI: 10.5826/dpc.0603a03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Valeria Zafeiriadou
- First Department of Dermatology-Venereology, Aristotle University Medical School, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Marina Papageorgiou
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Ioanna Mandekou-Lefaki
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
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Jakobiec FA, Rai R, Lefebvre DR. Papillary hidradenoma of the eyelid margin: clinical and immunohistochemical observations further supporting an apocrine rather than an eccrine origin. Surv Ophthalmol 2014; 59:540-7. [PMID: 24661803 DOI: 10.1016/j.survophthal.2014.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/26/2013] [Accepted: 01/08/2014] [Indexed: 11/18/2022]
Abstract
A 46-year-old woman was evaluated for a "recurring papilloma" of the left medial upper eyelid margin. Beneath the papillary lesion medial to the punctum was a 5-mm diameter cutaneous mass thought to be cystic. After excisional biopsy, histopathologic analysis documented the presence of an epidermal keratinizing squamous papilloma surmounting a circumscribed dermal papillary hidradenoma composed of deeply eosinophilic columnar cells. Additionally, there was intraductal proliferation of tumor extending toward a subclinical poral opening through the epidermis. Immunohistochemistry proved the apocrine nature of the benign, non-cystic lesion by virtue of its nuclear androgen receptor and cytoplasmic gross-cystic disease fluid protein-15 positivity, along with its smooth muscle actin-positive myoepithelial layer. This and prior cases establish that apocrine tumors, both benign and malignant, are strictly localized at or near the eyelid margin where only apocrine glands are found. These tumors are more often papillary than solid adenomas, and most exceptionally can be malignant. We review the differential diagnosis of simulating eccrine eyelid tumors. We recommend wide local excision for benign lesions, in view of possible intraductal extension that can be eccentric to the main tumor and the miniscule potential for malignant transformation.
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Affiliation(s)
- Frederick A Jakobiec
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Ruju Rai
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Daniel R Lefebvre
- Department of Ophthalmology, Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Abstract
PURPOSE Hidradenoma papilliferum (HP) is a cystic lesion of apocrine gland origin that occurs most commonly in the perineal region. Although there are scattered reports of HP involving the eyelid, to our knowledge, we present the first case of HP of the orbit. METHODS A 63 year-old female presented with progressive left upper eyelid fullness over an 18 month period. RESULTS The lesion was excised via transconjunctival anterior orbitotomy without incident. CONCLUSIONS The pathologic features of HP are presented.
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Affiliation(s)
- Steven E Katz
- Department of Ophthalmology, The Ohio State University, Columbus, OH 43212, USA.
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Abstract
Hidradenoma papilliferum is a benign adnexal tumor originating from apocrine glands of skin. It is commonly seen in the anogenital region of middle-aged women and presents as an asymptomatic, slow-growing, solitary nodule. Rarely this tumor occurs at extragenital sites and is called ectopic hidradenoma papilliferum. Although head and neck is a common site for this group, only 3 cases in the upper eyelid have been described. We present the first case of ectopic hidradenoma papilleferum presenting as a cystic swelling in the lower eyelid. A brief review of literature is included.
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Abstract
Long considered to be ectopic breast tissue representing the caudal remnants of the milk ridges, anogenital mammary-like glands are nowadays thought to represent a normal constituent of the anogenital area. Lesions involving these glands, benign or malignant, epithelial or stromal manifest a striking similarity to their mammary counterparts. This review addresses the recent literature on lesions of anogenital mammary-like glands and our personal experience with various lesions related to these structures. Discussed are the normal anatomy and histology of these glands as well as the clinical presentation, histopathological and immunohistochemical features, molecular biological aspects, and differential diagnosis of various lesions involving anogenital mammary-like glands, including lactating adenoma, hidradenoma papilliferum, hidradenocarcinoma papilliferum, fibroadenomas, phyllodes tumor, pseudoangiomatous stromal hyperplasia, extramammary Paget disease, and other carcinomas. In addition, "nonspecific" epithelial or stromal changes some of which can be likened to similar changes occurring in a range of benign breast disease, including sclerosing adenosis, columnar cell lesions, ductal lesions and various metaplastic changes affecting epithelium and myoepithelium are discussed. Although lesions of anogenital mammary-like glands are often discussed in many dermatopathology textbooks in the context of cutaneous adnexal neoplasms we advocate that the best approach to the diagnosis of these lesions is to relate them to analogous well recognized lesions occurring in the breast, that is, through the eyes of a breast pathologist. This will enable their recognition, precise classification and should introduce greater uniformity in how they are reported in the literature so that more meaningful clinicopathological comparisons and correlations may be made.
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Ectopic hidradenoma papilliferum. Dermatol Res Pract 2010; 2010:709371. [PMID: 21197082 PMCID: PMC3004393 DOI: 10.1155/2010/709371] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 11/02/2010] [Accepted: 11/17/2010] [Indexed: 11/17/2022] Open
Abstract
Hidradenoma papilliferum is a rare tumor that occurs almost exclusively in females on the anogenital area. Rare cases of ectopic (nongenital) hidradenoma papilliferum have been described. The lesions usually present as an asymptomatic slow-growing, red, firm, mobile, well-delimitated nodule that grows for a long time before resection. We describe a case of an 26-year-old man that presented with an enlarging nodule on his right eyelid. The histological findings revealed a hidradenoma papilliferum. So far, among the very few reports of ectopic hidradenoma papilliferum, only a very small number were localized to the eyelid.
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Daniel F, Mahmoudi A, de Parades V, Fléjou JF, Atienza P. An uncommon perianal nodule: Hidradenoma papilliferum. ACTA ACUST UNITED AC 2007; 31:166-8. [PMID: 17347625 DOI: 10.1016/s0399-8320(07)89349-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hidradenoma papilliferum is a rare, benign, cystic, papillary apocrine gland tumor that occurs almost exclusively in women in the skin of the anogenital region. We present the case of a 66 year old woman who presented with a progressively enlarging perianal nodule. We provide a review of the literature emphasizing the clinico-pathological characteristics and differential diagnosis. Local excision is necessary for identification and cure. No recurrence was observed after one year follow-up.
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Affiliation(s)
- Fady Daniel
- Unité de Proctologie, Service de Gastroentérologie, CHU Hôtel-Dieu de France, Université Saint Joseph, boulevard Alfred Naccache, Beyrouth, Liban
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Minami S, Sadanobu N, Ito T, Natsuaki M, Yamanishi K. Non-anogenital (ectopic) hidradenoma papilliferum with sebaceous differentiation: A case report and review of reported cases. J Dermatol 2006; 33:256-9. [PMID: 16674789 DOI: 10.1111/j.1346-8138.2006.00062.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Hidradenoma papilliferum is a benign tumor that usually occurs in the female anogenital region. We present a 52-year-old male with a non-anogenital (ectopic) hidradenoma papilliferum on his face. He had had a subcutaneous tumor on his right eyebrow for 30 years. The histological findings included variously shaped cystic and tubular structures in the tumor. The lumina were surrounded by a double layer of cells and showed active decapitation secretion. The lesion contained sebaceous differentiation, which has not been previously documented in the histopathology of hidradenoma papilliferum. We review the published work of non-anogenital (ectopic) hidradenoma papilliferum tumors on the head and neck.
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Affiliation(s)
- Shoichiro Minami
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
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Kazakov DV, Mikyskova I, Kutzner H, Simpson RHW, Hes O, Mukensnabl P, Bouda J, Zamecnik M, Kinkor Z, Michal M. Hidradenoma Papilliferum with Oxyphilic Metaplasia. Am J Dermatopathol 2005; 27:102-10. [PMID: 15798433 DOI: 10.1097/01.dad.0000154400.45465.a7] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reported here are 18 cases of hidradenoma papilliferum with oxyphilic metaplasia. All patients were women ranging in age from 29 to 74 years. Each presented clinically with a small, solitary tumor in the anogenital region. Microscopically, in addition to classic histopathological features, in every case there was oxyphilic metaplasia of the constituent epithelial cells. This finding could be likened to apocrine metaplasia, a term used in breast pathology. Other histopathological findings observed in this series, analogous to benign breast disease, included sclerosing adenosis-like changes, atypical apocrine adenosis-like changes, changes corresponding to usual ductal epithelial hyperplasia, epitheliomatosis with a streaming growth pattern, lamprocyte-like changes, clear cell change of the myoepithelium, foamy histiocyte reaction, and stromal fibrosis. Immunohistochemistry inferred that in the majority of cases oxyphilic metaplasia resulted from more lysosomes, whereas numerous mitochondria were detected in only 3 cases. Using 2 different PCR methods we identified HPV in 4 of 15 cases of hidradenoma with oxyphilic metaplasia. In addition, HPV was detected in 3 of 16 conventional papillary hidradenomas used as a control group. The following HPV types were identified: 16, 31, 33, 53, and 56. The last type was found in 5 cases. More than one HPV type from a single lesion was seen in 5 cases. Our observations are consistent with previous publications noting similarities between tumors of the breast and sweat glands. Oxyphilic metaplasia, areas with solid growth, and changes simulating atypical apocrine adenosis are rare and poorly recognized in hidradenoma papilliferum and may cause diagnostic difficulties; in our cases several submitting pathologists suspected malignancy. A causal role for HPV in hidradenoma papilliferum cannot be confirmed from our results, as the detection rate is too low. The exact role of the HPV in etiology and pathogenesis of this neoplasm has yet to be determined.
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Affiliation(s)
- Dmitry V Kazakov
- Sikl's Department of Pathology, Charles University, Medical Faculty Hospital, Pilsen, Czech Republic
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Fernández-Aceñero MJ, Sánchez TA, Sánchez MCV, Requena L. Ectopic hidradenoma papilliferum: a case report and literature review. Am J Dermatopathol 2003; 25:176-8. [PMID: 12652207 DOI: 10.1097/00000372-200304000-00024] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
We describe an unusual case of hidradenoma papilliferum on the chest of a man and discuss the rare sites of the tumor.
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Affiliation(s)
- Masaru Tanaka
- Department of Dermatology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
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Abstract
Extramammary fibroadenomas have been previously reported to mainly occur in the anogenital region, arising from mammary-like glands. The present report describes a 45-year-old woman who presented with a fibroadenoma of her eyelid that was associated with a cystadenoma. To our knowledge, this is the first case report of a fibroadenoma of the eyelid. The differential diagnosis and histogenesis of this lesion are discussed, and the literature pertaining to cutaneous fibroadenomas arising outside the breast is reviewed.
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
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Stefanato CM, Finn R, Bhawan J. Extramammary Paget disease with underlying hidradenoma papilliferum: guilt by association? Am J Dermatopathol 2000; 22:439-42. [PMID: 11048981 DOI: 10.1097/00000372-200010000-00010] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Extramammary Paget disease (EMPD) is a heterogenous entity representing either an intraepidermal adenocarcinoma in situ with apocrine differentiation or an expression of underlying malignancy of the skin or of the intestinal or genitourinary tract. The coexistence of EMPD with a benign underlying hidradenoma papilliferumn (HP) is, however, exceptional. We present the case of a 79-year-old woman with diffuse and patchy gray-white lesions involving her left vulva as well as an underlying 0.7-cm asymptomatic firm nodule. Histologically, the epidermis and dermis showed features characteristic of EMPD and HP, respectively. Malignant transformation in HP giving rise to EMPD in the overlying epithelium has been reported. In our case, however, failure to demonstrate continuity between the two lesions together with the lack of cytologic atypia, mitoses, and necrosis in the HP lends additional support to the possibility that the HP is "innocent" and that its association with EMPD is thus coincidental. A common histogenetic derivation of these two lesions from the mammary-like glands or from related germinative cells in the epidermis is suggested to explain this rare presentation.
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Affiliation(s)
- C M Stefanato
- Department of Dermatology, Boston University School of Medicine, Massachusetts, USA
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Abstract
Hidradenoma papilliferum is a benign, cystic, papillary tumor that occurs almost exclusively in women on the skin of the anogenital region. Nonanogenital (ectopic) hidradenoma papilliferum are rare. We describe a 72-year-old white man with an enlarging nodule in the region of the right triceps muscle; microscopic examination showed a hidradenoma papilliferum. The median age of patients with ectopic hidradenoma papilliferum is between 1 to 2 decades older than the average age range of lesion onset in patients with anogenital hidradenoma papilliferum. In contrast to anogenital hidradenoma papilliferum, nearly one half of the patients with ectopic hidradenoma papilliferum are men. Ectopic hidradenoma papilliferum occurs most frequently (60%) in the head and neck region. Eighty-five percent of cases are 1.5 cm in the greatest diameter or smaller. The race, clinical features, pathologic features, treatment, and prognosis for hidradenoma papilliferum occurring in anogenital and ectopic locations are similar.
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Affiliation(s)
- R Vang
- Department of Pathology and Laboratory Medicine, The University of Texas-Houston Medical School, USA
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Loane J, Kealy WF, Mulcahy G. Perianal hidradenoma papilliferum occurring in a male: a case report. Ir J Med Sci 1998; 167:26-7. [PMID: 9540295 DOI: 10.1007/bf02937549] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hidradenoma papilliferum is a rare apocrine gland tumour, described only once previously in a male. We present the second such case.
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Affiliation(s)
- J Loane
- Department of Pathology, Cork University Hospital, Ireland
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Martin RW, Corio RL, Hood AF, Katz M. Papillary cystadenoma of the lower lip mimicking hidradenoma papilliferum. J Cutan Pathol 1993; 20:525-7. [PMID: 8132876 DOI: 10.1111/j.1600-0560.1993.tb00681.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Diaz-Arias AA, Loy TS, DeSpain JD. Common Benign Cutaneous Tumors And Tumor-Like Lesions Of The Head And Neck. Otolaryngol Clin North Am 1993. [DOI: 10.1016/s0030-6665(20)30837-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Netland PA, Townsend DJ, Albert DM, Jakobiec FA. Hidradenoma papilliferum of the upper eyelid arising from the apocrine gland of Moll. Ophthalmology 1990; 97:1593-8. [PMID: 1965020 DOI: 10.1016/s0161-6420(90)32373-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Hidradenoma papilliferum is derived from apocrine sweat glands and was originally described as a tumor located in the anogenital area. The authors recently examined a 78-year-old man with a hidradenoma papilliferum at the margin of the upper eyelid. While the tumor was located in the dermis, serial sections showed a connection to the epidermis and neoplastic cells partially replacing a gland of Moll. There were glandular structures with luminal cells that showed apical decapitation-type secretion, indicating the apocrine origin of the tumor. The luminal cells also contained granules that stained with periodic acid-Schiff (PAS) stain and were diastase resistant. Results of examination of the duct-forming cells by transmission electron microscopy showed adluminal villi, focal decapitation secretion, luminal cytoplasmic debris, and electron-dense cytoplasmic secretory granules. Because the apocrine glands of Moll are localized adjacent to the eyelid cilia, hidradenoma papilliferum and other tumors of apocrine origin should be considered in the clinical setting of a mass at the eyelid margin.
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Affiliation(s)
- P A Netland
- Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston 02115
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Veraldi S, Schianchi-Veraldi R, Marini D. Hidradenoma papilliferum of the vulva: report of a case characterized by unusual clinical behavior. THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1990; 16:674-6. [PMID: 2163410 DOI: 10.1111/j.1524-4725.1990.tb00099.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The authors describe a case of hidradenoma papilliferum localized to the right labium majus of a 33-year-old woman. The young age of the patient, the rapid growth of the tumor, and its large size are elements that make the case atypical on the basis of the published literature.
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Affiliation(s)
- S Veraldi
- 1st Dermatology Clinic, University of Milan, Italy
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Kage M, Nakamura Y, Ozumi K. A case report of equivocal neoplasm originating from an apocrine gland on the eyelid. ACTA PATHOLOGICA JAPONICA 1990; 40:431-4. [PMID: 2203231 DOI: 10.1111/j.1440-1827.1990.tb01583.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We report a rare case of apocrine neoplasm with malignant potential. The patient, a 29-year-old man, had a nodule 1 cm in diameter on his left upper eyelid which had been growing slowly for several years. It was a cystic lesion, consisting of neoplastic cells of probable apocrine gland or Moll's gland origin. This opinion was based on the histological characteristics, which included eosinophilic cytoplasm accompanied with decapitation secretion, iron granules, and granular depositions which were stained positively with periodic acid-Schiff, with and without diastase digestion. Ferritin was found in their cytoplasm, a feature that has not been reported. It was uncertain whether the neoplasm was benign or malignant, because the cells showed nuclear atypia, characterized by variation in size and hyperchromasia, but lacked the histological features of malignancy, including infiltration into the adjacent tissue and mitosis.
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Affiliation(s)
- M Kage
- Department of Pathology, Saint Mary's Hospital, Kurume, Japan
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