Sonographic Characteristics of Apocrine Nodular Hidradenoma of the Skin

Diagnostic accuracy of high-frequency ultrasound for cutaneous neoplasms: a narrative review of the literature

High-frequency ultrasound has been used to visualize depth and vascularization of cutaneous neoplasms, but little has been synthesized as a review for a robust level of evidence about the diagnostic accuracy of high-frequency ultrasound in dermatology. A narrative review of the PubMed database was performed to establish the correlation between ultrasound findings and histopathologic/dermoscopic findings for cutaneous neoplasms. Articles were divided into the following four categories: melanocytic, keratinocytic/epidermal, appendageal, and soft tissue/neural neoplasms. Review of the literature revealed that ultrasound findings and histopathology findings were strongly correlated regarding the depth of a cutaneous neoplasm. Morphological characteristics were correlated primarily in soft tissue/neural neoplasms. Overall, there is a paucity of literature on the correlation between high-frequency ultrasound and histopathology of cutaneous neoplasms. Further studies are needed to investigate this correlation in various dermatologic conditions.

Key Points to Select a Device for Dermatologic Ultrasound

What points to consider when selecting a device for practicing dermatologic ultrasound is an excellent question. After we met the requisites published in the guidelines for practicing dermatologic ultrasound, it is necessary to consider the main objective of the use because it is not the same to be focused mostly on the avoidance of the puncture of important facial vessels such as the case of injectors of cosmetic fillers in comparison to the use of operators that need to deal with the diagnosis and monitoring of a wide range of dermatologic pathologies. Currently, a broad variety of ultrasound devices meets the minimum requirements for practicing these examinations in the market. Thus, small, portable, and high-end devices may present advantages and limitations that must be balanced according to the primary purposes and the budget. Moreover, the shape and footprint of the probes can make difficult or facilitate a dermatologic procedure. Other points to consider are the type of storage and the need for technical service. In summary, there are key points that we need to consider when we select a dermatologic ultrasound device in dermatology or aesthetics.

Sonographic and Strain Elastographic Findings of a Clear Cell Hidradenoma that Looked Like an Epidermoid Tumor: A Case Report

Clear cell hidradenoma (CCH) is a rare tumor of the sweat glands of eccrine or apocrine differentiation. It can occur anywhere in the body, but common sites of involvement are the head, face, trunk, and extremities. Although several reports have described sonographic findings of CCH, only one study on the axilla mentioned its strain elastographic findings. Here, we present a case of CCH in the right calf with its sonographic and strain elastographic findings in a tumor that looked like an epidermoid tumor.

Imaging findings of Bowen's disease: A comparison between ultrasound biomicroscopy and conventional high-frequency ultrasound

OBJECTIVES

To compare the imaging findings of Bowen's disease (BD) between ultrasound biomicroscopy (UBM) and conventional high-frequency ultrasound (HFUS).

METHODS

A total of 29 pathologically proven BD lesions in 28 patients were retrospectively enrolled in the study, and all were after surgery. All the lesions were imaged with both UBM and HFUS. The imaging features on HFUS and UBM were analyzed and compared. The diagnostic results of ultrasound for BD were referenced with pathology results.

RESULTS

All the 29 (100%) BD lesions appeared hypoechogenicity, solid component, and superficial hyperechoic layer (ie, keratinization) on both UBM and HFUS. The typical imaging feature of BD lesions, that was, infiltration depth confined to the epidermis, was visualized in 25 (86.2%, 25/29) lesions on UBM whereas 15 (51.7%, 15/29) on HFUS (P = .002). A "wave sign," which corresponds to the surface keratinization of BD lesion, was visualized in 17 (58.6%, 17/29) of BD lesions on UBM whereas 6 (20.7%, 6/29) on HFUS (P = .001). UBM and HFUS correctly diagnosed 25 (86.2%, 25/29) and 15 (51.7%, 15/29) BD lesions, respectively (P = .002).

CONCLUSIONS

Bowen's disease has some typical imaging features on US. The "wave sign" of the superficial hyperechoic layer and the clear borderline between the tumor in epidermis and the slightly hyperechoic dermis layer are better depicted by UBM in comparison with HFUS, which leads to a more accurate diagnosis of BD. UBM has potential to be used as a diagnostic tool for characterization of BD on account of its high resolution.

Malignant sweat gland tumor of breast arising in pre-existing benign tumor: A case report

BACKGROUND

Sweat glands belong to skin appendages. Sweat gland tumors are uncommon, especially when they occur as malignant tumors in the breast. We report a case of malignant sweat gland tumor of the breast, including imaging and pathological findings.

CASE SUMMARY

A 47-year-old woman visited our hospital with a non-tender palpable lesion in her left breast. The lesion had not shown changes for 10 years. However, it recently increased in size. Sonography showed a well circumscribed cystic lesion with internal debris and fluid-fluid level. Magnetic resonance imaging showed a well circumscribed oval mass with T1 hyper-intensity compared to muscle and T2 high signal intensity. There was a small enhancing mural component in the inner wall of the mass. The tumor was resected. Its pathologic result was a malignant transformation of benign sweat gland tumor such as hidradenoma. The lesion was treated with excision and radiation therapy. At 1-year follow up, there was no local recurrence or metastasis in the patient.

CONCLUSION

In the case of a rapid growing cystic mass in the nipple and subareola, it is necessary to distinguish it from a malignant sweat gland tumor.