Malignant nodular hidradenoma

Nodular Hidradenocarcinoma, Trichelemmal Carcinoma and Squamous Cell Carcinoma with Clear Cell Changes: Pitfalls of Biopsy Diagnosis of Skin and Adnexal Tumours

Skin and Adnexal tumours are a group of benign and malignant tumours whose basic diagnosis relies on histopathology. A single tumour may show more than 1 appendageal differentiation. Morphologic distinction between benign and its malignant counterpart is of utmost importance as it affects the treatment and prognosis of patient. We have described 3 cases who presented in our university hospital, in which final resection pathological diagnosis differed from initial core biopsy interpretation. The authors have made an attempt to provide a brief overview of diagnostic overlap existing between nodular hidradenocarcinoma and tumours of clear cell histology. Salient morphologic features differentiating cylindroma or trichilemmal carcinoma from squamous cell carcinoma have also been discussed. Final diagnosis is paramount for adjuvant management and prognostication of the patient in a clinical setting.

A Rare Tumor of the Face: Malignant Nodular Hidradenoma with Dermoscopic Features Mimicking Amelanotic Melanoma

Background:

Sweat gland neoplasms are rare neoplasms with less known dermoscopic features.

Observations:

By applying dermoscopy, we identified some common vascular features that have been defined for amelanotic melanoma such as hairpin vessels, dotted vessels, linear irregular vessels, glomerular vessels, and milky-red areas.

Conclusion:

Polymorphic vascular structures can also be seen in eccrine neoplasms. Further evaluations should be done to differentiate and identify the common dermoscopic features of other sweat gland tumors.

[Malignant nodular hidradenoma and multiple nodular hidradenomas in a hypogonadic patient]

BACKGROUND

We report a case of multiple benign nodular hidradenomas associated with malignant nodular hidradenoma in a hypogonadic patient.

CASE-REPORT

A 49 year-old man presented 11 benign nodular hidradenomas in the pectoral region. A malignant nodular hidradenoma had recently appeared in this region some distance from the pre-existing benign modular hidradenomas. This patient had peripheral hypogonadism associated with congenital bilateral cryptorchidia responsible for gynecomastia due to "relative hyperestrogenism". Large numbers of estrogen receptors were demonstrated in each of the benign nodular hidradenomas. The malignant nodular hidradenoma mass was unavailable and screening for these receptors was not possible.

DISCUSSION

Cases of multiple nodular hidradenoma are extremely rare: we have seen only two. To the best of our knowledge, there have been no reports to date of combined malignant nodular hidradenoma and multiple benign nodular hidradenoma. However, there is histological evidence of transition forms. The coexistence of endocrine anomalies associated with this type of tumour has never been reported. However, the presence of estrogen receptors has occasionally been demonstrated in benign nodular hidradenomas. Our patient's endocrine disease may have played a role in the presentation of multiple hidradenomas, but this cannot be demonstrated.

Clear-cell hidradenoma of the forearm in a young boy

We treated a 5-year-old boy with clear-cell hidradenoma of the forearm. Our literature search found only one previous report of this disease occurring during the first decade of life, and the present patient is the first with involvement of the limbs. This presentation demonstrates that clear-cell hidradenoma needs to be considered in the differential diagnosis of cutaneous tumors even in young children, which is of interest because malignant transformation can occur.