Spiradenoma, also spiroma or eccrine spiradenoma, is a cutaneous condition that is typically characterized, clinically, as a solitary, deepseated dermal nodule of approximately one centimeter, occurring on the ventral surface of the body 666 spiradenoma lesions are benign sudoriferous tumors, and have also been described as cystic epitheliomas of the sweat glands. Histochemistry of hidradenoma and eccrine spiradenoma. Malignant eccrine spiradenoma is a type of tumor that develops from a sweat gland in the skin. Well circumscribed, roundoval cell nests blue balls in dermis or subcutaneous. It is a rare variant of eccrine spiradenoma es, which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic.
Pdf giant vascular eccrine spiradenoma with unusual clinical. Eccrine spiradenoma es is a rare, benign adnexal neoplasm that. Purpose of this reporta small painful tumor of the skin, observed relatively often in the course of examination of neoplasms contributed to the armed forces institute of pathology, has been interpreted as a benign sweatgland adenoma. There is frequently a more prominent population of s100 positive dendritic cells while in eccrine spiradenoma there is a lymphocytic infiltrate. Two cases of malignant eccrine spiradenoma are reported and discussed.
The proportion of the two cell types varies considerably between tumors, and there may be cells that have features between the two extremes. As cytology was a new procedure for this tumor, the approach of choice appeared to be a holistic one. Malignant eccrine spiradenoma with carcinomatous and. Eccrine spiradenoma, giant vascular eccrine spiradenoma, sweat gland neoplasms introduction giant vascular eccrine spiradenoma gves is a variant of an eccrine spiradenoma. Eccrine spiradenoma and dermal cylindroma, journal of.
Ed fulton, for picking the slides and organizing them. Case report of solitary eccrine spiradenoma of eyelid. Diagnostics, new delhi, india accepted on february 25, 2019 introduction eccrine spiradenoma was described in 1956 by kersting and helwig who designated eccrine spiradenoma as a benign. Giant vascular eccrine spiradenoma with unusual clinical. Poroma eccrine poroma, hidroacanthoma simplex, dermal.
Malignant eccrine spiradenoma archives of pathology. In the present case, we are describing a case of eccrine spiradenoma of back, which was diagnosed by fineneedle aspiration cytology and subsequently confirmed by histopathology. A case of eccrine spiradenoma in a patient with neurofibromatosis. Eccrine carcinoma is an extremely rare malignancy of the skin with few well documented cases reported in the literature. Full length report histochemistry of hidradenoma and eccrine spiradenoma r. Jan 31, 2018 in this video we cover spiradenoma and cylindroma, two very closely related benign sweat gland neoplasms. Cylindroma in this tumour the low power view shows discrete polygonal tumour islands. The tumour is comprised of a diffuse dense basophilic cellular proliferation figures 1 and 2. Benign eccrine spiradenoma genetic and rare diseases. In our case, we present a 46 yearold female with a recurring exophytic tumor on the right lower extremity, without local extension. It usuallypresents asasolitary, intradermal, and painful nodule, the commonest sites being the chest andface. Not all stubbed toes are innocuousa case report of rare malignant eccrine spiradenoma spiradenocarcinoma of the toe.
Surgical excision was performed and the tissue was sent for histopathological examination. On microscopic examination, the lesion proved to be an eccrine spiradenoma. Nov 14, 2011 malignant eccrine spiradenoma is a type of tumor that develops from a sweat gland in the skin. A 44yearold male with a bluecolored, nodular tumor on the left knee, present for 10 years, was submitted for diagnosis.
Although eccrine poroma is known to be benign, it can slowly become a malignant tumor. Eccrine spiradenoma contains large lobules with a solid tubular pattern while cylindroma has irregularly shaped islands of cells separated by a hyalin stroma. Eccrine spiradenoma as a differential diagnosis in chronic. Eccrine spiradenoma is now known as a be nign sweat gland tumor that commonly affects young adults. In fact, the attribution of sweat gland neoplasms to eccrine or apocrine categories is often controversial,15,17 because most sweat gland carcinomas seem to recapitulate sweat ducts, which are histologically similar in eccrine and apocrine glands. This distinctive tumour is an adnexal tumour argued to arise from the apocrine or eccrine secretory coil or coiled duct histology of eccrine spiradenoma. However, the possibility of a primary basal cell epithelioma with eccrine differentiation and a lobular, hyalinised syringoma cylindroma should be included in the histological differential diagnosis. An unusual case of congenital linear eccrine spiradenoma. Eccrine spiradenoma is an adnexal neoplasm that continues to be designated as a tumor with eccrine differentiation, however, it is currently considered an apocrine process. The disease usually appears as solitary gray, purple, pink. Both usually present as a solitary, solid or partially cystic nodule with a slight preponderance in females of middle age.
Eccrine spiradenoma with chondroid syringoma in blaschkoid distribution. It typically arises within a preexisting eccrine spiradenoma that has been present for many years. Eccrine spiradenoma mimicking a painful traumatic neuroma. Jun 17, 2015 eccrine spiradenoma is an adnexal neoplasm that continues to be designated as a tumor with eccrine differentiation, however, it is currently considered an apocrine process. Benign adnexal tumor with eccrine differentiation, may be derived from the secretory coil see also topic in skinnonmelanocytic tumor chapter essential features. A case of multiple eccrine spiradenoma occurring on the scalp and mimicking multiple cylindroma. The disease usually appears as solitary gray, purple, pink, red, or blue nodules on the upper half of the body.
Eccrine spiradenoma is a benign adnexal neoplasm that has been historically designated as a tumor of eccrine differentiation, although current reconsideration indicates an apocrine process. In co ntrast, the malignant eccrine spiradenoma mes. Mar 16, 2020 webpathology is a free educational resource with 10231 high quality pathology images of benign and malignant neoplasms and related entities. They outline 22 cases of malignant eccrine spiradenoma with clinical features and outcomes. Spiradenomas are benign neoplasms originally thought to arise from sweat glands in the dermal layer of the skin. Studiesroutine studies with hematoxylin and eosin, periodic acidsehiff reaction pas with and without diastase, and alcian blue stains were performed.
We report a rare and original case of spiradenoma, presenting with multiple lesions in a segmental and blaschkoid arrangement with a secondary malignant transformation. Hidradenoma poroid hidradenoma hidradenoma refers to a tumor that includes both an eccrine and apocrine variant. David weedon ao md frcpa fcaphon, in weedons skin pathology third edition, 2010. Dec 16, 2019 the histogenesis of spiradenomas remains in question, but many lesions demonstrate apocrine differentiation. Report of a case with immunohistochemical study we report a rare case of giant vascular eccrine spiradenoma gves which developed in 56yrold korean woman. Eccrine spiradenoma spirodenoma dermatology advisor. The ratio of malignant transformation from eccrine poroma into eccrine porocarcinoma is 18%, as reported by robson et al. It presents as solitary lesions in 97% of all the cases multiple tumors have been reported on the chest, upper extremities of the forehead, and scalp. Malignant eccrine spiradenoma mes is an extremely rare sweat gland tumor that arises in a preexisting benign eccrine spiradenoma. In contrast, the malignant eccrine spiradenoma mes. The present case corresponds to a low grade malignant spiradenoma but with.
The results of studies using light microscopy, transmission electron microscopy and immunohistology are described. Eccrine spiradenocarcinoma is a rare sweat gland tumour. A retrospective, descriptive and observational study was conducted in which clinical characteristics of patients with diagnosis of eccrine spiradenoma confirmed by histopathology. Eccrine spiradenoma es is a rare, benign adnexal neoplasm that may easily be mistaken for glomus lesions or angioleiomyoma due to its painfulness and florid vascularization. Low grade malignant eccrine spiradenoma of the vulva. Gves is very rare and differs from the eccrine spiradenoma in its larger size clinically and marked vascularity histopathologically. In the available literature wecould find no case ofeccrine spiradenoma of the eyelids. Malignant eccrine spiradenoma with squamoid and chondroid.
Comparisons of our data with reports in the literature revealed that rare histologic descriptions of this adenoma undoubtedly have appeared during the past century. Metastatic spiradenocarcinoma occurring in an 8yearold boy. Multiple eccrine spiradenoma an unusual clinical presentation. They are common in young adults and are without a sex predilection. However, eccrine porocarcinoma does not always arise from eccrine. The term eccrine acrospiroma was coined by johnson and helwig for a morphologically diverse group of tumors, which are thought to differentiate toward or originate from the distal part of the sweat duct. Aug 14, 2014 eccrine spiradenoma es is a rare, benign adnexal neoplasm that may easily be mistaken for glomus lesions or angioleiomyoma due to its painfulness and florid vascularization.
The pain was frequently spontaneous but could always. Therefore, histopathologic examination is required for definitive diagnosis of poroma. Solitary, painful, slowly growing, pinkgray lesion, often 1cm. Spiradenoma, also spiroma or eccrine spiradenoma, is a cutaneous condition that is typically characterized, clinically, as a solitary, deepseated dermal nodule of approximately one centimeter, occurring on the ventral surface of the body. Diagnosing and treating patients with persistent neuropathic pain associated with peripheral nerve lesions can be challenging.
Spiradenoma is a rare and benign cutaneous tumor of unknown etiology. Benign eccrine spiradenoma is an adnexal tumor that occurs as either a solitary lesion or as multiple nodules. Dec 16, 2019 spiradenomas are benign neoplasms originally thought to arise from sweat glands in the dermal layer of the skin. The tumour is comprised of a diffuse dense basophilic cellular. It is thought to develop from eccrine sweat glands and most often presents as a solitary and painful nodule. Winkelmann, md klaus wolff, md mayo clinic and mayo foundation, section of dermatology mayo clinic and mayo foundation, section of dermatology mayo graduate school of medicine university of minnesota, rochester mayo graduate school of medicine university of minnesota rochester recipient of. This is especially true of the monomorphic adenoma, eccrine spiradenoma and cylindroma. The pain was frequently spontaneous but could always be initiated by pressure, including even the weight of a bedsheet. Six patients were men, six were women, and the average patient age was 62 years.
Early in our experience with these tumors it became apparent. Two examples of a variant of benign spiradenoma are reported, both characterized by their large size and high degree of vascularity. Case report of solitary eccrine spiradenoma of eyelid touchophthalmology 2 appears between 15 to 35 years of age. Spiradenoma, also known as spiroma or eccrine spiradenoma, was first reported in 1956 by kersting et al1. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. In our case, this tumor was present on the right side of chest. Seven tumors were located on the trunk, three on the extremities, and two in the head and neck region. O multiple eccrine spiradenoma journal of krishna institute of. The clinicopathologic features of 12 cases are reported herein. Eccrine spiradenoma is a benign adnexal tumor that presents as a small, typically tender, and bluish nodular lesion mainly in the upper body. Malignant eccrine spiradenoma is a very rare tumor. Among the terms applied to the tumor by different authors were spiradenoma, hidradenoma, syringoma, hydradenoma, sweatgland adenoma, cylindroma, and myoepithelioma. Eccrine spiradenoma is an uncommon, benign tumor originating from the sweat glands.
Smears showed clusters of round to plasmacytoid cells with moderate to abundant cytoplasm embedded in a chondromyxoid ground substance. Eccrine nodular hidradenoma eyelid diseases central. First case was a 20 year old female who presented with firm,nontender swelling in the left little finger measuring 1 cm in diameter. Article pdf available in open journal of pathology 0402. In eccrine spiradenocarcinoma, sections show areas of benign eccrine spiradenoma with an abrupt transition in morphology figures 1, 2. It is frequently found on the lower extremities, and it equally affects both sexes in the sixth and seventh decade. Pdf eccrine spiradenoma is one of the rare adnexal tumors with. It starts as a rapidlygrowing bump on the head or abdomen, and may cause tenderness, redness, or an open wound. Giant vascular eccrine spiradenoma with unusual clinical presentation.
The presentation is often that of a single nodule that may or may not be tender. Pubmed is a searchable database of medical literature and lists journal articles that discuss benign eccrine spiradenoma. A rare case of eccrine spiradenomatreatment and management. The term eccrine spiradenoma may join the list of other misnomers in dermatology, including mycosis fungoides and granuloma faciale. Theeccrinespiradenomais abenignneoplasmofthe skin first described by kersting and helwig, who considered it to be a derivative of eccrine sweat glands. Eccrine spiradenoma is now known as a benign sweat gland tumor that commonly affects young adults. The authors report the rare case of a painful eccrine spiradenoma treated as a traumatic neuroma for many years because of a history of acute trauma, the presence of a tender palpable mass, and symptoms of allodynia. It differs from eccrine spiradenoma in its larger size and vascularity as well as propensity for bleeding and ulcerati\ on, which may cause a clinical misdiagnosis of vascular lesion or malignant tumor. Fine needle aspiration cytology of eccrine spiradenoma of. Eccrine spiradenoma is a rather rare adnexal tumor of the skin. Half of the tumor was frozen for histochemical studies. Webpathology is a free educational resource with 10287 high quality pathology images of benign and malignant neoplasms and related entities. Low power view of eccrine spiradenoma shows a wellcircumscribed tumour nodule arising within the dermis or superficial subcutis. It is crucial to take eccrine spiradenoma into consideration in superficial.
The duration of an episode varied widely, depending on whether there were aggravating factors, but was usually about 10 minutes. Malignant eccrine spiradenoma genetic and rare diseases. Here we report a case of eccrine spiradenoma of the breast skin in a 39yearold woman who presented with a breast nodule for 10 years. Eccrine spiradenoma and dermal cylindroma gerber, j. Differential diagnosis of eccrine spiradenoma pathology. Jul 30, 2018 eccrine spiradenoma is a benign adnexal tumor that presents as a small, typically tender, and bluish nodular lesion mainly in the upper body. The differential diagnosis includes adenoid cystic carcinoma arising within a spiradenoma, cylindroma and spiradenoma collision tumor, microcystic change within a spiradenoma, mucinous carcinoma arising within a spiradenoma, and trichoepithelioma and spiradenoma collision tumor. We describe a case of malignant eccrine spiradenoma of a 41yearold male with a history of swelling over nape of neck for 6 yrs and recent onset of increase in size since 6 months. Trichoepithelioma and spiradenoma collision tumor mdedge. Lung stained with haematoxylin and eosin 1 middle diameter bronchus 2 epithelium of the mucosa 3 lamina propria of the mucosa 4 lamina muscularis of the mucosa 5 tunica submucosa 6 fibroelastic layer 7 tunica adventitia 8 alveoli 9 interstitial connective tissue of the lung 10 glands in. When the clinical presentation is that of a breast neoplasm, diagnosis can be difficult. Sep 09, 2015 malignant eccrine spiradenoma mes is an extremely rare sweat gland tumor that arises in a preexisting benign eccrine spiradenoma. Giant vascular eccrine spiradenoma \gves\ is a rare variant of eccrine spiradenoma \es\, a tumor that develops from the sweat gland.
Icd03 histology code to text translation dhs icd03, histology, code, text, translation. Eccrine spiradenoma, also spiradenoma, is usually a benign, painful skin thingy. Eccrine spiradenomas are uncommon, benign lesions, which are thought to originate from the eccrine sweat glands. The exact cause of malignant eccrine spiradenoma is unknown, though it is thought that sun exposure or problems with the immune system. They are usually benign dermatological condition which are characterized, clinically, as a solitary, deepseated, painful, slowgrowing, dermal nodule of approximately one centimeter, occurring on the ventral surface of the body. Differential diagnosis these can be confused with many skin lesions. Jul 31, 20 dermatopathology reference describes eccrine spiradenoma histopathology including histologic features and provides links to additional medical references. Eccrine spiradenoma is one of the rare adnexal tumors with eccrine differentiation. They were first described in 1956 by kersting and helwig as a distinct form of sweat gland tumor,which they called eccrine spiradenoma. Histopathology of poroma reveals a circumscribed tumor of uniform basaloid or poroid cells extending from the epidermis into the upper dermis with few pale larger cells and small ducts andor cysts scattered within figure 2, figure 3. Conclusions made included discussion of the wide spectrum of histologic variants found in malignant eccrine spiradenoma. We describe a case of malignant eccrine spiradenoma of a 41yearold male with a history of swelling over nape of neck f or 6yrs and recent onset of increase in size since 6 months.
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