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Alizadeh M, Zisman E, Wong U. Hidradenocarcinoma in a Crohn's patient on ustekinumab: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241254732. [PMID: 39071199 PMCID: PMC11282559 DOI: 10.1177/2050313x241254732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 04/25/2024] [Indexed: 07/30/2024] Open
Abstract
Hidradenocarcinoma is a locally aggressive malignancy of the sweat glands, most commonly found on the head, neck, and upper body. Although rare, it has been seen in patients with hidradenitis supparativa, who have an increased risk of non-melanoma skin cancers. Ustekinumab, a biologic agent used to treat inflammatory bowel disease, has been associated with development of cancer in some patients. We present a case of a 36-year-old female with hidradenitis supparativa and Crohn's disease who developed hidradenocarcinoma in setting of ustekinumab use, demonstrating the need for further study of the relationship between biologic therapy and malignancy.
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Affiliation(s)
- Madeline Alizadeh
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Erin Zisman
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Uni Wong
- Department of Veterans Affairs, Washington DC Veterans Health Administration, Washington, DC, USA
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2
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McCrary MR, Beekman KE, Strosberg C, Turner L, Sanik E, Beachkofsky TM. A rare case of hidradenocarcinoma with anaplastic and invasive features arising from a nodulocystic hidradenoma. J Cutan Pathol 2024. [PMID: 39022841 DOI: 10.1111/cup.14686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/01/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024]
Abstract
A 91-year-old man presented with a cutaneous left abdominal mass. The mass was longstanding (over 5 years) and slow-growing. Examination revealed a violaceous, multinodular, and exophytic non-tender mass surrounded by patchy erythema. Excisional biopsy was performed and revealed a nodular and cystic dermal proliferation of predominately basaloid cells with focal duct formation, surrounded by prominent hyalinized stroma. The superficial portion of the mass was identified as a nodulocystic hidradenoma. Along the deep aspect and in association with the benign hidradenoma, sheets of markedly atypical epithelioid cells invaded the surrounding tissue, consistent with malignant transformation. Perineural and lymphovascular invasion were seen among areas with anaplastic features. This case supports that some hidradenocarcinoma originates from benign counterparts, and as such, ample sampling is required to definitively exclude a more sinister diagnosis. Diagnostic, prognostic, histopathological, and molecular characteristics, and current knowledge limitations are briefly discussed.
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Affiliation(s)
- Myles R McCrary
- Anatomic and Clinical Pathology, USF Health Morsani College of Medicine, Tampa, Florida, USA
| | - Kate E Beekman
- USF Health Morsani College of Medicine, Tampa, Florida, USA
| | - Carolina Strosberg
- Anatomic and Clinical Pathology, James A. Haley Veterans' Hospital, Tampa, Florida, USA
| | - Leslie Turner
- Anatomic and Clinical Pathology, James A. Haley Veterans' Hospital, Tampa, Florida, USA
| | - Eugene Sanik
- Department of Dermatology, James A. Haley Veterans Hospital, Tampa, Florida, USA
| | - Thomas M Beachkofsky
- Department of Dermatology, James A. Haley Veterans Hospital, Tampa, Florida, USA
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3
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Wan L, Park A, Khachemoune A. Syringocystadenocarcinoma papilliferum: a systematic review of clinical characteristics, reappraisal of associations, diagnostic pitfalls and management challenges. Arch Dermatol Res 2024; 316:421. [PMID: 38904691 DOI: 10.1007/s00403-024-03176-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 05/21/2024] [Accepted: 06/08/2024] [Indexed: 06/22/2024]
Abstract
Syringocystadenocarcinoma papilliferum (SCACP) is a rare and aggressive malignant adnexal tumor originating from apocrine or pluripotent appendageal glands, often associated with a preceding syringocystadenoma papilliferum (SCAP) or nevus sebaceus (NS). This systematic review rigorously examines SCACP through an analysis of 78 cases documented between 1980 and 2024. The study aims to provide a comprehensive review of the clinical manifestations, diagnosis, treatment modalities, and outcomes associated with SCACP, while also reappraising its associations, particularly with NS. SCACP predominantly affects older adults, with an average age of 66.3 years and a slight male predominance, commonly presenting as ulcerated nodules or plaques on the scalp. This review highlights the aggressive nature of SCACP, evidenced by significant rates of metastasis and recurrence. Treatment is primarily surgical, with Mohs micrographic surgery offering potential benefits in terms of margin control and cosmetic outcomes. The association of SCACP with NS is critically evaluated, suggesting a complex etiopathogenesis and underscoring the importance of recognizing this association for timely diagnosis and management. Our review also briefly discusses potential pitfalls faced by clinicians in the diagnosis of SCACP. Our findings emphasize the need for standardized treatment protocols and further research into targeted therapies to improve patient outcomes in SCACP.
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Affiliation(s)
- Leo Wan
- West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
| | - Aileen Park
- University of Colorado Anschutz School of Medicine, Aurora, CO, USA
| | - Amor Khachemoune
- Department of Dermatology, SUNY Downstate, 450 Clarkson Ave, Brooklyn, NY, USA.
- State University of New York Downstate and Veterans Affairs Medical Center, 800 Poly Pl, Brooklyn, NY, 11209, USA.
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Kent S, Jeha GM, Qiblawi S, Malinosky H, Greenway HT, Kelley B. Hidradenocarcinoma: A Case Series From the Scripps Clinic With a Systematic Review of the Literature. Dermatol Surg 2024; 50:507-511. [PMID: 38460197 DOI: 10.1097/dss.0000000000004140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
BACKGROUND Hidradenocarcinoma (HAC) is a rare adnexal carcinoma. To the best of the authors' knowledge, there are no published systematic reviews on HAC. OBJECTIVE To incorporate a case series from the authors' institution and systematically integrate reported information to provide a reference tool for optimization of diagnosis and management. METHODS A comprehensive MEDLINE search was conducted from database inception to 2021 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This yielded 225 studies with 165 cases of HAC. References of included articles were also searched. In addition, 9 patients with HAC were identified from the authors' institution over the past 10 years. RESULTS The mean age of HAC presentation is 60 years with a slight male predilection (60%). The head and neck is the most commonly affected region. Over 36% of cases either presented with metastatic disease or went on to metastasize. The most common treatment type was wide local excision, followed by Mohs micrographic surgery. CONCLUSION Early detection with accurate histologic interpretation is prudent in all cases of HAC. Wide local excision is the current first-line treatment. However, Mohs micrographic surgery offers complete marginal analysis with evidence of reduced risk of metastasis and better outcomes compared with wide local excision. Currently, there are no National Comprehensive Cancer Network guidelines for the treatment of HAC, and consensus guidelines are limited to tumor and nodal metastasis staging provided by the American Joint Committee on Cancer, eighth edition. Thus, this case series and systematic review integrates important aspects of diagnosis, workup, and management of HAC.
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Affiliation(s)
- Steven Kent
- Bighorn Mohs Surgery and Dermatology Center, Scripps Clinic, La Jolla, CA
| | - George M Jeha
- Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Hannah Malinosky
- Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Benjamin Kelley
- Louisiana State University Health Sciences Center, New Orleans, LA
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5
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Rosatti F, Orlando E, Alecci G, Ferraù F, Cordova A. Metastatic hidradenocarcinoma papilliferum in chronic hidradenitis: an emblematic case and a narrative review. Arch Dermatol Res 2024; 316:265. [PMID: 38795204 DOI: 10.1007/s00403-024-03028-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 04/17/2024] [Accepted: 04/26/2024] [Indexed: 05/27/2024]
Affiliation(s)
- F Rosatti
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, 90127, Italy.
| | - E Orlando
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, 90127, Italy
| | - G Alecci
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, 90127, Italy
| | - F Ferraù
- Dipartimento Oncologico, UOC Oncologia, Ospedale "S. Vincenzo", Taormina, Italy
| | - A Cordova
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, 90127, Italy
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Terzić Z, Paunovic M, Popovic A, Vukmirovic F, Bojić M. Transformation of recurrent hidradenoma into a metastatic hidradenocarcinoma in a 31-year old female patient. Postepy Dermatol Alergol 2023; 40:820-823. [PMID: 38282879 PMCID: PMC10809825 DOI: 10.5114/ada.2023.133588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/02/2023] [Indexed: 01/30/2024] Open
Affiliation(s)
- Zoran Terzić
- Department of Plastic Surgery, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Marinko Paunovic
- Department of Plastic Surgery, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Ana Popovic
- Department of Dermatovenerology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Filip Vukmirovic
- Department of Pathology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Miloš Bojić
- Department of Plastic Surgery, Clinical Center of Montenegro, Podgorica, Montenegro
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Zhang Z, Yin S, Xu Z, Wang S. Sweat Gland Carcinoma of the Head and Neck: Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023; 102:NP522-NP526. [PMID: 34134535 DOI: 10.1177/01455613211016717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The main aim of this article is to discuss and summarize the research advancements and the treatment methods for sweat gland carcinoma (SGC) based on 2 cases of SGC in our hospital and the related literature. CASE REPORT This article presents 2 patients with SGC who were treated in the China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases from 2007 to 2019. We analyzed the clinical features, therapies, and prognosis of the patients and searched for related literatures. DISCUSSION Two patients underwent extended resection for local lesions with no adjuvant radiotherapy. Neither local recurrence nor distant metastasis was detected during follow-up. Reviewing previous literature, the treatment of SGC includes surgical resection, radiotherapy, and chemotherapy. We have not found an effective treatment. The prognosis of SGC occurred in head and neck is relatively good compared with another primary-site location, primary surgical excision with safe resection margins and neck dissection is recommended.
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Affiliation(s)
- Zeliang Zhang
- Department of Oral and Maxillofacial Surgery, Affiliated Heping Hospital, Changzhi Medical College, Changzhi Shanxi, China
| | - Shoucheng Yin
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Zhongfei Xu
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Shuai Wang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
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Alves DG, Araújo C, Sousa J, Lapa A, Abreu de Sousa J. Hidradenocarcinoma of the Female Breast: A Surgical Approach to a Rare Skin Tumor. Cureus 2023; 15:e42577. [PMID: 37641751 PMCID: PMC10460289 DOI: 10.7759/cureus.42577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
Clear-cell hidradenocarcinomas are extremely uncommon sweat gland tumors with a predilection for the head and neck. In the limited number of articles reporting breast involvement, the primary focus concerns this entity's histological and immunohistochemical characteristics. Since hidradenocarcinomas of the breast have the potential to resemble a primary breast carcinoma closely, diagnosis may be challenging. Therefore, the authors report the first case of hidradenocarcinoma of the breast, which features its macroscopic morphology. In addition, to increase physicians' awareness of this rare neoplasm, the article also aims to detail its surgical approach.
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Affiliation(s)
| | - Cláudia Araújo
- Surgical Oncology, Instituto Português de Oncologia do Porto, Porto, PRT
| | - Jessica Sousa
- Radiology, Centro Hospitalar Universitario do Porto EPE, Porto, PRT
| | - Alexandra Lapa
- Anatomical Pathology, Instituto Português de Oncologia do Porto, Porto, PRT
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9
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Elouaouch S, El Youssi Z, Mansouri H, Nadir M, Bennani A, Guerrouaz MA, Moukhlissi M, Berhili S, Mezouar L. Localized Hidradenocarcinoma of the Scalp: A Case Report. Cureus 2023; 15:e38675. [PMID: 37288227 PMCID: PMC10243552 DOI: 10.7759/cureus.38675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/09/2023] Open
Abstract
Hidradenocarcinomas or malignant hidradenomas are tumors developed from the sweat glands, in particular, the eccrine glands. It is a rare entity of skin tumors and frequently appears de novo with a slight female predominance and an average age of 50 years at diagnosis. We report the case of a 57-year-old woman treated for localized hidradenocarcinoma of the scalp, successfully managed by surgery and adjuvant radiotherapy.
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Affiliation(s)
- Sofia Elouaouch
- Radiation Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Zahira El Youssi
- Radiation Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Hanane Mansouri
- Radiation Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Miry Nadir
- Anatomopathology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Amal Bennani
- Anatomopathology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | | | - Mohamed Moukhlissi
- Radiation Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Soufiane Berhili
- Radiation Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Loubna Mezouar
- Radiation Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
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10
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Larnaudie A, Giraud P, Naessens C, Stefan D, Clavère P, Balosso J. Radiotherapy of skin adnexal carcinoma. Cancer Radiother 2023:S1278-3218(23)00062-8. [PMID: 37080860 DOI: 10.1016/j.canrad.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 04/22/2023]
Abstract
Skin adnexal carcinomas are rare skin cancer, developing from pilosebaceous, eccrine and apocrine unit. Treatment of localised tumours usually includes surgery and radiotherapy. Indications and modalities of radiotherapy depend on the pathological subtype with a lack of consensus for some histologies. This review summarises the place of radiotherapy in terms of indication, dose and fractionation, volumes to irradiate and discuss ongoing studies.
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Affiliation(s)
- A Larnaudie
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France; Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France.
| | - P Giraud
- Radiation Oncology, Pitié Salpêtrière, Charles-Foix University Hospital, 47-83, boulevard de l'hôpital, 75013 Paris, France; Médecine Sorbonne universités, 91-105, boulevard de l'hôpital, 75013 Paris, France
| | - C Naessens
- Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - D Stefan
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - P Clavère
- Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - J Balosso
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
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Zorro S, Matias R, Sousa C, Aguiar A. Malignant Transformation of Retroauricular Hidradenoma in Hidradenocarcinoma in a Nine-Year-Old Patient: A Case Report. Cureus 2023; 15:e37160. [PMID: 37153249 PMCID: PMC10161949 DOI: 10.7759/cureus.37160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/09/2023] Open
Abstract
Hidradenocarcinoma, a rare malignant entity that derives from sweat glands, is especially rare in the pediatric population. The treatment of choice is surgery. Radiation therapy is used only in selected patients. Chemotherapy is not used extensively because its effectiveness has not been demonstrated yet. This case report describes a nine-year-old female patient who presented in 2018 with a vegetative lesion in the right parietal region. After excisional surgery, pathology confirmed that the lesion was a benign hidradenoma. However, the lesion recurred six months later, and subsequent surgery revealed nodular hidradenoma with positive margins. In July 2019, a new heterogenous lesion appeared in the right retroauricular region, which was surgically removed. The pathology report found possible malignant characteristics, and the patient was referred to our hospital where she was diagnosed with poorly differentiated right retroauricular carcinoma with infiltrative and perineural permeation, along with homolateral lymph node metastasis. It was histologically compatible with a hidradenocarcinoma. The patient underwent a wide-margin excision and homolateral total cervical lymphadenectomy, followed by adjuvant radiotherapy. The last follow-up MRI was negative for disease recurrence or metastasis; however, a slow-growing node on the left jugular chain (level II) was noted. The patient is on regular follow-ups to monitor disease status and treatment-related adverse events. This case highlights the challenges of diagnosing and treating hidradenocarcinoma, a rare malignancy that requires aggressive management with a multidisciplinary approach. More robust clinical evidence is needed to define the best treatment approach for these aggressive tumors.
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TRPS1 Is Differentially Expressed in a Variety of Malignant and Benign Cutaneous Sweat Gland Neoplasms. Dermatopathology (Basel) 2023; 10:75-85. [PMID: 36810569 PMCID: PMC9944056 DOI: 10.3390/dermatopathology10010011] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Neoplasms of sweat glands and the breast may be morphologically and immunophenotypically similar. A recent study showed that TRPS1 staining is a highly sensitive and specific marker for breast carcinoma. In this study, we analyzed TRPS1 expression in a spectrum of cutaneous sweat gland tumors. We stained five microcystic adnexal carcinomas (MACs), three eccrine adenocarcinomas, two syringoid eccrine carcinomas, four hidradenocarcinomas, six porocarcinomas, one eccrine carcinoma-NOS, 11 hidradenomas, nine poromas, seven cylindromas, three spiradenomas, and 10 syringomas with TRPS1 antibodies. All of the MACs and syringomas were negative. Every cylindroma and two of the three spiradenomas demonstrated intense staining in cells lining the ductular spaces, with negative to relatively weak expression in surrounding cells. Of the 16 remaining malignant entities, 13 were intermediate to high positive, one was low positive, and two were negative. From the 20 hidradenomas and poromas, intermediate to high positivity was revealed in 14 cases, low positivity in three cases, and negative staining in three cases. Our study demonstrates a very high (86%) expression of TRPS1 in malignant and benign adnexal tumors that are mainly composed of islands or nodules with polygonal cells, e.g., hidradenomas. On the other hand, tumors with small ducts or strands of cells, such as MACs, appear to be completely negative. This differential staining among types of sweat gland tumors may represent either differential cells of origin or divergent differentiation and has the potential to be used as a diagnostic tool in the future.
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Muacevic A, Adler JR, Aaronson NL. Atypical Nodular Hidradenoma Versus Low-Grade Hidradenocarcinoma in a Young Female Patient: A Case Report and Review of Literature. Cureus 2022; 14:e32772. [PMID: 36694537 PMCID: PMC9858785 DOI: 10.7759/cureus.32772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
The objective of this study was to discuss an unusual postauricular mass in a pediatric patient. This mass had a broad differential including congenital anomaly, neoplasm, infection, and lymphovascular malformation. Atypical nodular hidradenoma is a rare adnexal tumor that is difficult to differentiate from hidradenocarcinoma. It is a rare entity, but especially rare in the pediatric population. This study aims to provide guidance on diagnosing hidradenoma and distinguishing it from hidradenocarcinoma through case presentation with a review of the literature. The patient in this report underwent wide location resection with close surveillance and has been disease-free during follow-up.
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14
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Alshareef BH, Ghazzawi RA, Sheikh GE. Nodular hidradenocarcinoma of the forehead presenting as a lipoma: A case report with a review of literature. Int J Surg Case Rep 2022; 101:107795. [PMID: 36434872 PMCID: PMC9685281 DOI: 10.1016/j.ijscr.2022.107795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/07/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Hidradenocarcinoma is an uncommon slow-growing malignant tumor that originates from sweat glands, it is most seen in the head and neck, and present typically as hard asymptomatic nodule. Diagnosis is confirmed by histopathology and immunohistochemistry, and wide local excision is the mainstay of the treatment. In our study, we discuss the approach and management of this rare disease, with focusing on the importance of histopathology in diagnosing such cases. PRESENTATION OF CASE We present a very rare case of a 58-year-old female who presented with painless slow growing forehead swelling for 2 years, with clinical feature suggestive of lipoma. The patient underwent surgical excision, and post-operative histopathological examination of the specimen was consistent with nodular hidradenocarcinoma. DISCUSSION Hidradenocarcinoma is a very rare malignant tumor that was first reported in 1954. This tumor was reported to be more common in males, and the incidence increases with age. The origin of hidradenocarcinoma is mostly de novo. The definitive diagnosis requires histopathological examination, and wide local excision is the mainstay of the treatment. CONCLUSION Hidradenocarcinoma is a very rare sweat gland malignancy, and the diagnosis can be challenging. In our study, we emphasize the importance of raising the awareness among the surgical oncology society regarding this rare tumor, and we discuss the approach and management of such an uncommon disease, with focusing on the importance of histopathology in diagnosing such cases.
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Affiliation(s)
- Basem H Alshareef
- Department of General Surgery, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
| | - Raghad A Ghazzawi
- Department of Otorhinolaryngology - Head and Neck Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Ghofran E Sheikh
- Department of General Surgery, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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15
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Adnexal and Sebaceous Carcinomas. Dermatol Clin 2022; 41:117-132. [DOI: 10.1016/j.det.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Saternus R, Vogt T. Maligne Adnextumoren der Haut. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1774-9678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungNeoplasien der Hautadnexe (benigne oder maligne) können zum einen von den Talgdrüsen oder Haarfollikel ausgehen, zum andern auch eine Differenzierung Richtung ekkriner oder apokriner Schweißdrüsen zeigen. Auch Mischformen können vorkommen. Maligne Adnextumoren entstehen i. d. R. de novo. Dennoch ist auch die maligne Entartung einer vorbestehenden benignen Läsion möglich.Maligne Adnextumoren der Haut sind im Vergleich zu anderen nicht-melanozytären Hauttumoren insgesamt eine eher seltene Entität. Jedoch zeigt sich, dass die Inzidenz von malignen Adnextumoren in den letzten Jahren zugenommen hat. Ähnlich wie bei anderen Hautkrebsarten sind auch bei malignen Adnextumoren das Alter, UV-Strahlung und Immunsuppression wichtige Risikofaktoren der Tumorgenese.Da sich die Klinik sowohl von malignen als auch benignen Adnextumoren mit Ausnahme des Morbus Paget oftmals ähneln kann und wenig spezifisch ist, kommt der Histopathologie für die korrekte Diagnosestellung eine entscheidende Bedeutung zu.Gemäß der Literatur sind die häufigsten malignen Adnextumore das Talgdrüsenkarzinom (23 %), der extramammäre Morbus Paget (19 %), das Hidradenokarzinom (15 %), das Porokarzinom (7 %) sowie das mikrozystische Adnexkarzinom (MAC) (5 %). Während manche Vertreter prognostisch mit einem Basalzellkarzinom vergleichbar sind (MAC), sind andere durchaus metastasierungsfähig vergleichbar den Plattenepithelkarzinomen (Talgdrüsenkarzinom, Porokarzinom). Andere Vertreter heben sich hier prognostisch besonders negativ ab mit hoher Lokalrezidivquote und Metastasierung, z. B. das Hidradenokarzinom.Dieser Übersichtsartikel fokussiert sich auf diese 5 relativ häufigen Adnex-Malignome, die prognostisch auch die gegebene Streubreite wiedergeben und die Erfordernis einer den jeweiligen Besonderheiten geschuldeten klinischen Versorgung und Nachbetreuung unterstreichen.
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Affiliation(s)
- Roman Saternus
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, D-66421 Homburg/Saar
| | - Thomas Vogt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, D-66421 Homburg/Saar
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17
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Current Treatment Options for Cutaneous Adnexal Malignancies. Curr Treat Options Oncol 2022; 23:736-748. [DOI: 10.1007/s11864-022-00971-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/03/2022]
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18
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Kawaguchi M, Kato H, Noda Y, Kobayashi K, Miyazaki T, Hyodo F, Matsuo M. Imaging findings of malignant skin tumors: radiological-pathological correlation. Insights Imaging 2022; 13:52. [PMID: 35316414 PMCID: PMC8941041 DOI: 10.1186/s13244-022-01205-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/04/2022] [Indexed: 11/11/2022] Open
Abstract
Sometimes, radiologists encounter malignant skin tumors (MSTs) during image interpretation. As MSTs require different clinical management modalities for each histological subtype, accurate preoperative diagnosis is essential. The histological subtypes of MST can be easily assessed by visual inspection or biopsy. Therefore, the significant role of radiological imaging in MSTs is to evaluate the extent of local invasion, nodal involvement, and distant metastasis, and the histological estimation of MSTs by radiological imaging has not been reported until a few years ago. However, recent studies have revealed characteristic radiological features for differential diagnosis of MSTs, such as configuration, intratumoral homogeneity, signal intensity, cyst formation, and hemorrhage. Other important clinical data for determining the histological subtype of MST include age, gender, and site of occurrence. MSTs can be categorized as epidermal, melanocytic, adnexal, and mesenchymal tumors based on the origin and have distinctive characteristics. Hence, this review article was designed to describe the clinical and radiological features of MSTs.
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Affiliation(s)
- Masaya Kawaguchi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | | | | | - Fuminori Hyodo
- Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
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Martins D, Pereira F, Azevedo R, Julião I. Eccrine Hidradenocarcinoma of the Scalp. Cureus 2022; 14:e23023. [PMID: 35419234 PMCID: PMC8994172 DOI: 10.7759/cureus.23023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 01/03/2023] Open
Abstract
Eccrine hidradenocarcinoma is a rare adnexal neoplasm arising from the eccrine sweat glands of the skin. Surgery and radiotherapy are the mainstay of treatment, and chemotherapy is reserved for unresectable or metastatic lesions. We present the case of a 60-year-old man, referred for treatment of an unresectable basal cell carcinoma of the scalp. He started Vismodegib in January of 2017 but progressed after three months. A new biopsy showed a poorly differentiated carcinoma. The patient started carboplatin/paclitaxel with a major response, enabling surgery in December of 2017. Pathology concluded on a hidradenocarcinoma, R1, and radiotherapy was not possible due to local infection. Four months later, he underwent radiotherapy due to local recurrence, and restarted carboplatin/paclitaxel, but with progressive disease. An exploratory surgery in October of 2018 revealed unresectable disease. Restaging showed lung metastasis and second-line chemotherapy was proposed. However, due to continued clinical deterioration, the patient died in February of 2019.
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20
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Sanchez Saz J, Sanz Medrano S, Nielsen L, Buendia Perez J, Manrique Gamo E, Cebrian Parra JL. Hidradenocarcinoma over a Surgically Excised Hidradenoma of the Foot. A Case Report of a Very Rare Presentation of a Rare Tumor. J Orthop Case Rep 2022; 12:49-53. [PMID: 36660147 PMCID: PMC9826554 DOI: 10.13107/jocr.2022.v12.i05.2812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/20/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction Hidradenocarcinomas are very rare and aggressive soft-tissue tumors, originated from sweat gland cells, which are located most frequently in head and neck, being their appearance at the extremities rare. This kind of tumor usually appears de novo and very few cases have been reported until now of appearance over benign lesions such as hidradenomas. Malignancy progression rate of hidradenomas is unknown, and this benign lesion has clinical and histopathological characteristics in common with hidradenocarcinomas that could lead to misdiagnosis. Hidradenocarcinomas have a very poor survival rate; therefore, an early diagnosis is essential for a better prognosis, and that is the reason why hidradenomas should be widely excised from the beginning, instead of performing marginal resections of this lesions that could lead to an aggressive recurrence. Case Presentation Here is a case report of a 27-year-old woman diagnosed with a hidradenocarcinoma over a previously excised hidradenoma in the right foot. The diagnosis was made after right pelvic and inguinal lymphadenopathies appeared few months after a new small asymptomatic lump appeared at the same place in the sole of the right foot were the excised hidradenoma five years before was located. Lymph node biopsy was performed, with histopathological diagnosis of hidradenocarcinoma metastasis. Surgical local wide excision of the lump at the foot and lymphadenectomies was performed. Histopathological analysis of the samples confirmed the diagnosis of hidradenocarcinoma. The patient later received adjuvant radiotherapy and after one year there are no signs of disease recurrence. Conclusion Many questions remain uncertain about the management and treatment of hidradenocarcinomas due to the rarity of this type of tumor. Although targeted molecular therapies have shown promising results, more studies in this field are necessary. An early diagnosis and differentiation from its benign counterparts that allow local control of the disease before spreading is essential to improve survival rates.
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Affiliation(s)
- Jaime Sanchez Saz
- Department of Orthopaedic Oncology, Orthopaedic Surgery and Traumatology, Hospital Clinico San Carlos, Madrid, Spain,Address of Correspondence: Dr. Jaime Sanchez del Saz, Calle Profesor Martin Lagos, s/n, Madrid - 28040, Spain. E-mail:
| | - Santiago Sanz Medrano
- Department of Plastic and Reconstructive Surgery, Hospital Clinico San Carlos, Madrid, Spain
| | - Luna Nielsen
- Department of Histopathology, Hospital Clinico San Carlos, Madrid, Spain
| | - Javier Buendia Perez
- Department of Plastic and Reconstructive Surgery, Hospital Clinico San Carlos, Madrid, Spain
| | - Elena Manrique Gamo
- Department of Orthopaedic Oncology, Orthopaedic Surgery and Traumatology, Hospital Clinico San Carlos, Madrid, Spain
| | - Juan Luis Cebrian Parra
- Department of Orthopaedic Oncology, Orthopaedic Surgery and Traumatology, Hospital Clinico San Carlos, Madrid, Spain
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21
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Hydroadenocarcinoma, a rare tumor to be kept in mind. ORAL AND MAXILLOFACIAL SURGERY CASES 2021. [DOI: 10.1016/j.omsc.2021.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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22
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McGauran MF, Manolitsas T, Tawfik B, Joshi D, Lamont JM. Poroid hidradenocarcinoma and atypical hidradenoma papilliferum of the vulva – Two cases. Gynecol Oncol Rep 2021; 38:100886. [PMID: 34926767 PMCID: PMC8651789 DOI: 10.1016/j.gore.2021.100886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/19/2021] [Indexed: 12/01/2022] Open
Abstract
Benign and malignant tumours may arise from eccrine and apocrine sweat glands. Hidradenocarcinoma is a rare malignant eccrine sweat gland tumour representing <0.01% of all skin cancers. There are 6 case reports in the literature of hidradenocarcinoma arising on the vulva, none of which are classified as poroid hidradenocarcinoma. Hidradenocarcinoma is thought to be an aggressive tumour with poor prognosis and high levels of local recurrence and systemic metastases. Conversely, hidradenoma papilliferum is a common benign apocrine sweat gland tumour found on the vulva. The prevalence and significance of atypical changes, however, is unknown. Distinguishing between these tumour types can be difficult. The authors present two cases, a poroid hidradenocarcinoma and an atypical hidradenoma papilliferum with necrosis and increased mitotic activity, to illustrate the diagnostic challenges associated with rare tumours of the vulva in the absence of an established histopathological classification system.
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Affiliation(s)
- Monica F.G. McGauran
- Department of Gynaecological Oncology, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Corresponding author at: Mercy Hospital for Women, 163 Studley Road, Heidelberg 3078, Victoria, Australia.
| | - Tom Manolitsas
- Department of Gynaecological Oncology, Monash Health, Clayton, Victoria, Australia
- Cabrini Hospital, Malvern, Victoria, Australia
| | - Bassam Tawfik
- Melbourne Pathology, East Melbourne, Victoria, Australia
| | - Dhaval Joshi
- Melbourne Pathology, East Melbourne, Victoria, Australia
| | - Julie M Lamont
- Department of Gynaecological Oncology, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Epworth Healthcare, East Melbourne, Victoria, Australia
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23
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Coco D, Leanza S, Campagnacci R. Clear Cell Hidradenocarcinoma: a Rare Identity Difficult to Recognize - Case Report and Review of the Literature. MAEDICA 2021; 16:526-530. [PMID: 34925613 PMCID: PMC8643562 DOI: 10.26574/maedica.2020.16.3.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hidradenocarcinoma (HC) is a malignant and aggressive sweat gland tumour. It is a rare occurrence, accounting for about 6% of malignant eccrine cancers and less than 1% of all cutaneous neoplasms. It is a malignant tumor which can manifest itself in any area of the body, including the anterior surface of the trunk, the torso, scalp, face, and extremities. It is apparent that HC has a high propensity for lymphatic metastasis. The suggested treatment approach for HC implies making a wide surgical excision with negative margins. Nevertheless, such tumours are aggressive and recur locally in 50% of cases; they also produce metastases in 60% of cases. The overall five-year survival rate is 30%. Here, we present the case of a 68-year-old Caucasian male with unknown diagnosis of malignant neoplasm of inguinal cutaneous skin of sweat gland called hydrocarcinoma.
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Affiliation(s)
- Danilo Coco
- Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro (PU), Italy
| | - Silvana Leanza
- Department of General Surgery, Carlo Urbani Hospital, Jesi (AN), Italy
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24
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[Management of malignant adnexal neoplasms of the skin]. Hautarzt 2021; 72:619-632. [PMID: 34137901 DOI: 10.1007/s00105-021-04829-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
Malignant adnexal neoplasms of the skin are a heterogeneous group of rare malignancies with eccrine, apocrine, sebaceous and follicular differentiation. Essential clinical practice recommendations for the overall management of these cancers are presented. Moreover, specific evidence-based findings according to diagnosis, therapy and follow-up of porocarcinoma, sebaceous carcinoma and microcystic adnexcarcinoma will be explained.
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25
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Gonzalez-Lopez G, Garrido-Ruiz MC, Rios-Martin JJ, Rodriguez-Peralto JL. Three Cases of Clear Cell Hidradenoma With "Benign" Lymph Node Involvement. Am J Dermatopathol 2021; 43:e76-e79. [PMID: 33464750 DOI: 10.1097/dad.0000000000001886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The malignant counterpart of cutaneous clear cell hidradenoma (CCH), hidradenocarcinoma, is an aggressive neoplasm that may have a fatal outcome. However, some cases of benign looking CCH with isolated lymph node involvement and excellent prognosis have been described. "CCH-like neoplasm of uncertain malignant potential" or "atypical hidradenoma" have been proposed as designations for these lesions. We report 3 cases of CCH with lymph node involvement. Ages ranged from 29 to 51 years old. All cases involved the inguinal lymph nodes: 2 of them presented with an isolated lymph node lesion, and the third case had lymph node and cutaneous involvement following the resection of a previous cutaneous lesion. Imaging studies showed no systemic involvement. None of the lesions exhibited histopathologic features of malignancy. All neoplasms were well circumscribed, had cystic spaces, did not display atypia or necrosis, and had less than 4 mitoses per high power field. No recurrence has been observed at follow-up after resection in all cases. All published cases of CCH with lymph node involvement so far affected a single lymph node in the axillary or inguinal regions, lacked features of malignancy, and had excellent long-term prognosis. Some cases previously reported as hidradenocarcinoma probably fit into this category. Our series adds more evidence to this rare phenomenon of "benign metastasis." Aggressive treatment should be avoided in these cases, and a long-term follow-up is warranted.
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Affiliation(s)
- Guillermo Gonzalez-Lopez
- Department of Pathology, Hospital Universitario Doce de Octubre, Universidad Complutense, Instituto de Investigación I+12, Madrid, Spain; and
| | - Maria C Garrido-Ruiz
- Department of Pathology, Hospital Universitario Doce de Octubre, Universidad Complutense, Instituto de Investigación I+12, Madrid, Spain; and
| | - Juan J Rios-Martin
- Department of Pathology, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | - Jose L Rodriguez-Peralto
- Department of Pathology, Hospital Universitario Doce de Octubre, Universidad Complutense, Instituto de Investigación I+12, Madrid, Spain; and
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26
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Fitzgerald TL. Invited Commentary. J Am Coll Surg 2021; 232:898-899. [PMID: 34030851 DOI: 10.1016/j.jamcollsurg.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/01/2021] [Indexed: 11/26/2022]
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27
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Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation. Int J Mol Sci 2021; 22:ijms22105077. [PMID: 34064849 PMCID: PMC8151110 DOI: 10.3390/ijms22105077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary treatment, affecting their outcome. The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors.
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28
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Rehman R, Squires B, Osto M, Quinn T, Kabolizadeh P. Hidradenocarcinoma of the Abdominal Wall Treated With Wide Surgical Excision and Adjuvant Radiotherapy. Cureus 2021; 13:e14724. [PMID: 34094723 PMCID: PMC8169006 DOI: 10.7759/cureus.14724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Hidradenocarcinomas are rare malignant sweat gland tumors that typically arise in the head and neck area. To the best of our knowledge, this is the only reported instance of hidradenocarcinoma of the abdominal wall as well as the first case arising from a region of prior trauma. A 72-year-old female presented with a left abdominal wall lesion, which she had first noticed after an injury to the area. Initially, the lesion remained stable in size, after which it became mildly pruritic, progressive in size, and expressive of a clear, non-odorous discharge. Imaging demonstrated a heterogeneous cystic density. Surgical pathology revealed a malignant dermal adnexal neoplasm composed of pleomorphic polygonal cells and focal intracytoplasmic lumina lined by eosinophilic cuticles, as well as areas of ductal differentiation, apocrine differentiation, and mucinous metaplasia. Surgical excision of the mass was performed, followed by adjuvant external beam radiotherapy (EBRT). The patient had no long-term toxicities or clinical evidence of local disease recurrence as of one year post-surgery and six months post-EBRT. Early diagnosis and treatment are essential to improving outcomes in patients with hidradenocarcinomas. Frequent follow-up is equally important, as these tumors have high recurrence rates.
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Affiliation(s)
- Rafey Rehman
- Department of Radiation Oncology, Beaumont Health, Royal Oak, USA
| | - Bryan Squires
- Department of Radiation Oncology, Beaumont Health, Royal Oak, USA
| | - Muhammad Osto
- Department of Dermatology, Wayne State University School of Medicine, Detroit, USA
| | - Thomas Quinn
- Department of Radiation Oncology, Beaumont Health, Royal Oak, USA
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29
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Rownose CS, Mohamad Saupi MS, Sharif SZ, Lah NASN. Aggressive scalp and sternal lesion: A presentation of rare case of metastatic eccrine carcinoma. Ann Med Surg (Lond) 2021; 65:102322. [PMID: 33996055 PMCID: PMC8091880 DOI: 10.1016/j.amsu.2021.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Ductal Eccrine carcinoma (DEC) is a rare primary cutaneous tumor that exhibits both squamous and adnexal ductal differentiation. Due to its rarity in clinical practice we present as case of DEC and a literature review on the latest management of this rare disease. Case presentation We report a case 41 years old female presented with lesion on the scalp and sternal mass, increasing in size with itchiness and erythematous for 6 months duration. Further CECT scan of brain and neck shows features of malignant left frontal scalp lesion with poor plane with overlying skin and underlying skull bone and CECT of thorax shows a large, irregular heterogeneously enhancing mass with necrotic center noted at right hilar within superior segment of right lower lobe, encasing right middle and lower lobe bronchi. Wedge biopsy of scalp lesion showed an intradermal lesion extensively infiltrating by malignant gland accompanied by desmoplasia and the tumor cells are seen extending into the surgical margins suggestive of ductal eccrine carcinoma. Clinical Discussion:This case highlights the importance and challenges in achieving early diagnosis coupled with the scarcity of information on these leads to difficulty in managing this patient. Conclusion In managing Ductal Eccrine Carcinoma tumor, standard method of treatment for has not been established. However, wide surgical excision is the treatment of choice for localized lesions. Regarding prognosis, there is conflicting data published which we describe in this article. We report a case 41 years old female presented with aggressive lesion on the scalp and sternal mass which biopsy confirm Ductal Eccrine Carcinoma (DEC). This case highlights the importance and challenges in achieving early diagnosis and surgical intervention for DEC. Most cases are detected at an advanced stage which leads to a poor prognosis. In managing DEC, due to its rarity of this disease, it require multidisciplinary approach to get the best outcome for the patient.
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Affiliation(s)
- Cha Sha Rownose
- Surgical Department, Faculty of Medicine & Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | | | - Nik Amin Sahid Nik Lah
- Surgical Department, Faculty of Medicine & Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Corresponding author.
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30
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Shanmugam G, Chidambaram B, Princess Beulah D, Manimohan V. Malignant adnexal tumour of the shoulder-a rare case report. J Surg Case Rep 2021; 2021:rjab025. [PMID: 33884163 PMCID: PMC8046015 DOI: 10.1093/jscr/rjab025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 01/31/2021] [Indexed: 11/12/2022] Open
Abstract
Malignant adnexal tumours are a very rare and highly aggressive primary skin neoplasms. Among them, malignant hidradenocarcinoma is a particularly aggressive tumour that arises from the intradermal duct of eccrine sweat glands. It more commonly arises de novo and rarely from a pre-existing hidradenoma. It is an aggressive tumour with regional lymph nodal and distant visceral metastasis. The prognosis is poor with a 5-year survival rate of 30%. Here, we present a 48-year-old female who came with a swelling over the left shoulder. On examination, it appeared to be chronic sebaceous cyst. The patient underwent wide local excision and the specimen was diagnosed as malignant nodular hidradenocarcinoma. Subsequent re-excision and sentinel lymph node biopsy was performed and margins were found to be microscopically negative for tumour. Based on the available literature wide local excision and sentinel lymph node biopsy appear to be the most common initial treatment plans.
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Affiliation(s)
- Giridharan Shanmugam
- Department of General Surgery, Government Stanley Medical College, Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
| | - Balamurugan Chidambaram
- Department of General Surgery, Government Stanley Medical College, Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
| | - D Princess Beulah
- Department of General Surgery, Government Stanley Medical College, Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
| | - Vignesh Manimohan
- Department of General Surgery, Government Stanley Medical College, Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
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31
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Smith CG, DeSimone CP. Invasive Hidradenocarcinoma of the Vulva: A Case Report and Literature Review. J Gynecol Surg 2021. [DOI: 10.1089/gyn.2020.0116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Christopher G. Smith
- Division of Gynecologic Oncology, Department of Gynecology & Obstetrics, Emory University, Atlanta, Georgia, USA
| | - Christopher P. DeSimone
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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32
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Aziz KT, Levin AS, Cuda JD, Ficke JR. Poroid Hidradenocarcinoma of the Ankle: Case Report of a Rare Malignant Cutaneous Adnexal Neoplasm. J Foot Ankle Surg 2021; 59:423-426. [PMID: 32131015 DOI: 10.1053/j.jfas.2019.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/13/2019] [Accepted: 08/18/2019] [Indexed: 02/03/2023]
Abstract
Soft-tissue masses on the anterior ankle result from a broad range of underlying processes, often presenting a diagnostic challenge. Appropriate treatment of these tumors can be determined by using a combination of patient history, interpretation of pathologic findings, physical examination, and radiographic appearance. We present a case of an exceptionally rare malignant cutaneous adnexal tumor, highlighting the importance of adherence to fundamental biopsy principles for diagnosing and managing musculoskeletal lesions.
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Affiliation(s)
- Keith T Aziz
- Resident, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
| | - Adam S Levin
- Assistant Professor, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
| | - Jonathan D Cuda
- Associate Professor, Department of Pathology, Marshall University School of Medicine, Huntington, WV
| | - James R Ficke
- Professor, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.
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33
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Malignant Hidradenocarcinoma Initially Diagnosed as an Apocrine Hidrocystoma: a Case Report and Literature Review. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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34
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A Case for a Local Flap as Primary Reconstruction for Hidradenocarcinoma of the Leg. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2780. [PMID: 33133887 PMCID: PMC7572152 DOI: 10.1097/gox.0000000000002780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/25/2020] [Indexed: 11/26/2022]
Abstract
Hidradenocarcinomas are rare, aggressive sweat gland tumors typically occurring in the scalp and upper extremities. They have rarely been described in the lower extremity. Due to their rarity, there is little consensus on optimal adjuvant therapy for these tumors after resection. Regardless, it is important to plan tumor excision and subsequent reconstruction with adjuvant therapy in mind. This case report describes a patient for whom a local muscle flap with skin graft provided adequate wound coverage after excision of hidradenocarcinoma and negative-pressure wound therapy. The surgical site then withstood adjuvant radiation therapy. When radiation is planned to a wound bed after tumor excision, a local muscle flap is the excellent first choice over skin graft alone regardless of wound bed characteristics.
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Rafols M, Mejia O, Oh KS, Bendixen B, Jorge I, Narayanan S. An Unusual Case of Lower Extremity Clear Cell Hidradenocarcinoma. Case Rep Surg 2020; 2020:6192109. [PMID: 32328335 PMCID: PMC7171610 DOI: 10.1155/2020/6192109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/17/2020] [Indexed: 11/29/2022] Open
Abstract
Hidradenocarcinoma (HC) is a rare malignant sweat gland tumor with metastatic potential primarily located in the head, neck, and trunk. We present an unusual case of a large lower extremity Clear Cell HC managed with surgical resection and adjuvant locoregional radiation after excluding lymph node involvement.
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Affiliation(s)
- Marc Rafols
- Department of General Surgery, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
| | - Odille Mejia
- Department of Pathology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
| | - Kei Shing Oh
- Department of Pathology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
| | - Blake Bendixen
- Florida International University Herbert Wertheim College of Medicine, Miami, FL 33199, USA
| | - Irving Jorge
- Department of General Surgery, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
| | - Sumana Narayanan
- Department of Surgical Oncology, Mount Sinai Comprehensive Cancer Center, Miami Beach, FL 33140, USA
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Objective Clinical and Radiological Response under Sunitinib in a Case of Thigh Hidradenocarcinoma. Case Rep Oncol Med 2020; 2020:9656475. [PMID: 32158575 PMCID: PMC7060839 DOI: 10.1155/2020/9656475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/13/2020] [Indexed: 11/17/2022] Open
Abstract
A 56-year-old male was treated by local surgery in 1968 and 2005 for a left thigh lesion. A 2nd local relapse occurred in 2015 and was treated by complete macroscopic surgery with histology concluding to a hidradenocarcinoma. A 3rd locoregional relapse occurred in October 2018, with the presence of inflammatory ulcerated lesions. A 2nd histology and immunohistochemistry exam showed a proliferation positive for CK, CK5, and p63 suggesting the diagnosis of hidradenocarcinoma. The patient was treated by 3 lines of chemotherapy, 1st by Adriamycin, 2nd by carboplatin-paclitaxel, and then 3rd by oral capecitabine, leading to a stable clinical disease but without a clinical benefit. A locoregional plus metastatic lung progression was observed in March 2019, with the presence of lung nodules and retroperitoneal lymph nodes, multiple skin left thigh and left inguinal ulcerated lesions. The patient received then in 4th line in April 2019 oral sunitinib at 50 mg daily, with 4 weeks therapy/2 weeks pause. Side effects were represented by mucositis, anorexia, weight loss, and fatigue. We observed since the 1st week of therapy a fast response, with a decrease of the ulcerated lesions, a skin loss, and deep hemorrhagic areas. CT-scan showed after 2 weeks of sunitinib an objective response on both locoregional and metastatic lesions.
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Abstract
Malignant hidradenocarcinoma is a very rare and highly aggressive primary skin neoplasm that arises in the eccrine sweat glands. Diagnosis is typically made with histopathological evaluation after excisional biopsy. Reports of this tumor are scarce in the literature, thus making its characterization and management particularly challenging. A 71-year-old male presented in the clinic with swelling of the left lateral axilla on routine dermatological examination. Clinically, the lesion was suspected to be a capillary hemangioma. Upon surgical excision, the specimen was diagnosed as malignant hidradenocarcinoma based on histological characterization with immunohistochemical staining. Subsequent wide excision with sentinel lymph node biopsy was performed, which came back negative for residual tumor and metastasis. Due to the low incidence of this cancer and the markedly poor prognosis, accurate diagnosis of these tumors is highly important. Wide excisional biopsy and sentinel lymph node biopsy appear to be the most common initial treatment plans based on the available literature. With high rates of recurrence and metastasis, there remains the need to characterize effective adjuvant therapy for the post-operative management of hidradenocarcinoma.
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Affiliation(s)
- Evan P Johnson
- Orthopaedics, University of Central Florida College of Medicine, Orlando, USA
| | - Jonathan Keyes
- Internal Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Vania Zayat
- Pathology, University of Central Florida College of Medicine, Orlando, USA.,Orlando Veterans Affairs Medical Center, Orlando, USA
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Shen J, Pan X, Lu Y, Pan D, Ma Y, Zhan R. A case of eccrine porocarcinoma characterized by a progressive increase in the level of Ki-67 index: case report and review of literature. BMC Surg 2019; 19:142. [PMID: 31601219 PMCID: PMC6785884 DOI: 10.1186/s12893-019-0595-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/29/2019] [Indexed: 11/13/2022] Open
Abstract
Background Eccrine porocarcinoma is an extremely rare skin adnexal malignant neoplasia with highly invasive and metastatic potential. We report an additional case of eccrine porocarcinoma with intracranial metastases. This case is characterized by a complete record of the progress of eccrine porocarcinoma, its immunohistochemistry after three operations showed a progressive increase in the level of Ki-67 index. Case presentation We herein report a case of a 37-year-old-male with eccrine carcinoma occurring on the left posterior occipital scalp which invaded the skull and dura, presenting with progressive headache. This patient has performed three surgeries in total. During the last hospitalization, he underwent an extended surgical resection, lymphadenectomy, myocutaneous flap transplantation and vascular anastomosis in our institution. After surgery, he was treating with radiotherapy at 200 Gray in 12 fractions. But one year after the operation, he developed chest tightness, imaging examination and biopsy puncture revealed pulmonary metastasis. Conclusion Intracranial metastasis of eccrine porocarcinoma is a late event with poor prognosis. This case emphases on that progressively increased level of Ki-67 index may predict more chance to occur the intracranial metastasis of scalp eccrine porocarcinoma, long-term follow-up and appropriately dense follow-up interval is necessary.
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Affiliation(s)
- Jie Shen
- Department of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, Hangzhou, China
| | - Xinfa Pan
- Department of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, Hangzhou, China
| | - Yongfu Lu
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, Hangzhou, China
| | - Desheng Pan
- Department of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, Hangzhou, China
| | - Yuehui Ma
- Department of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, Hangzhou, China.
| | - Renya Zhan
- Department of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, Hangzhou, China.
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Barbosa JABA, Ribeiro CTDA, Grinblat B, Cardoso APG, Weltmann E, de Oliveira EC, Yorioka MAW, Borges LL. Hidradenocarcinoma of the Scrotum. Urology 2019; 133:e13-e14. [PMID: 31302136 DOI: 10.1016/j.urology.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 05/28/2019] [Accepted: 07/04/2019] [Indexed: 10/26/2022]
Abstract
Lesions of the skin and soft tissues of the penis and scrotum may be confusing in urological practice, since rare differential diagnoses can be challenging to providers with limited dermatological experience. Hidradenocarcinoma is one of such diagnoses, a rare and aggressive malignant tumor originating from sweat glands. A 61 year-old man presented with a nodule in the penoscrotal region which had appeared 1 year before consultation. He had no history of penile lesions, sexually transmitted diseases, or other complaints. Surgical resection revealed a hidradenocarcinoma of the scrotum infiltrating subcutaneous tissue.
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Affiliation(s)
| | | | - Beni Grinblat
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Eduardo Weltmann
- Hospital Israelita Albert Einstein, São Paulo, Brazil; University of São Paulo Medical School, São Paulo, Brazil
| | | | - Marco A Watanabe Yorioka
- Hospital Israelita Albert Einstein, São Paulo, Brazil; University of São Paulo Medical School, São Paulo, Brazil
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Kane B, Adler E, Bhandari T, Rose M, DiGuglielmo N, Sun X. Malignant Hidradenocarcinoma in the Lower Extremity: A Case Report of a Rare Tumor. J Foot Ankle Surg 2018; 57:618-621. [PMID: 29472169 DOI: 10.1053/j.jfas.2017.10.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Indexed: 02/03/2023]
Abstract
Malignant hidradenocarcinomas are rare soft tissue tumors of sweat gland origin. We present the case of a soft tissue, fungating tumor of 15 years' duration of the medial ankle in an 85-year-old male that exhibited malignant features clinically and radiographically. Subsequent punch biopsy revealed a diagnosis of malignant hidradenocarcinoma. Given the risk of recurrence and the poor radiation and chemotherapy options, the patient initially decided to leave the lesion untreated. However, he soon developed lower extremity cellulitis from the exposed lesion and decided to have the tumor excised, eliminating the source of the infection. In the present case study, we discuss the etiology, clinical and radiographic characteristics, and treatment options for this rare lesion. At the 18-month follow-up visit, he had had no recurrence of the lesion.
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Affiliation(s)
- Brendan Kane
- Podiatry Resident Postgraduate Year 3, Jersey Shore University Medical Center, Neptune, NJ.
| | - Evan Adler
- Podiatry Attending Physician, Adler Foot and Ankle, Oakhurst, NJ
| | - Tarun Bhandari
- General Surgeon - Oncology, Atlantic Shore Surgical Associates, Brick, NJ
| | - Michael Rose
- Plastic Surgeon, The Plastic Surgery Center, Shrewsbury, NJ
| | | | - Xiu Sun
- Pathologist, Jersey Shore University Medical Center, Neptune, NJ
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López Rojo I, Gómez Ramirez J, Tejedor Togores P, Rivas Fidalgo S, Díaz Miguel M. Hydroadenocarcinoma of clear cells located in the breast. Cir Esp 2017; 96:308-310. [PMID: 29033066 DOI: 10.1016/j.ciresp.2017.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/22/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022]
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Abstract
BACKGROUND Adnexal carcinomas (ACs) are rare cutaneous malignancies of sweat gland or pilosebaceous origin. Optimal treatment and metastatic potential of AC are poorly defined. Mohs micrographic surgery (MMS) has been increasingly used to treat AC. OBJECTIVE To review selected primary cutaneous AC and their treatment outcomes with MMS. MATERIALS AND METHODS Literature review using PubMed search for articles related to primary cutaneous ACs. RESULTS Sebaceous carcinoma treated with MMS recurred and metastasized in 6.4% and 3.7%, respectively. Primary cutaneous mucinous carcinoma treated with MMS recurred and metastasized in 9.6% and 6.4%, respectively. After MMS, 4.7% of microcystic AC recurred with no reported metastases. After MMS, recurrences and metastases of trichilemmal carcinoma or hidradenocarcinoma have not been reported. Two (4.2%) regional lymph node metastases but no distant metastases or local recurrences have been reported in eccrine porocarcinoma. Squamoid eccrine duct tumor, pilomatrix carcinoma, and spiradenocarcinoma treated with MMS are also reviewed. CONCLUSION The rarity of ACs and the lack of comparative data on treatment makes conclusive recommendations on treatment difficult. Recent large case series and reviews suggest MMS is a useful and possibly superior treatment for AC and should be considered if primary cutaneous disease is suspected.
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Kim S, Cho J, Park W, Choi SH, Park W, Jang KT, Lee J. HER2, estrogen receptor-negative metastatic hidradenocarcinoma: identification of TP53 mutation in both primary and cell-free DNA. PRECISION AND FUTURE MEDICINE 2017. [DOI: 10.23838/pfm.2017.00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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High Relative Expression of Pannexin 3 (PANX3) in an Axillary Sweat Gland Carcinoma With Osteosarcomatous Transformation. Am J Dermatopathol 2016; 38:846-851. [DOI: 10.1097/dad.0000000000000583] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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