Clinical image inset and dermoscopy of 5 cases of eccrine poroma. As tumors in other organs, tumors of the eyelid can be classified according to their tissue or cell of origin and as benign or malignant. Nests lobules of cells resembling eccrine poroma with either clear cytoplasm or prominent squamous metaplasia. The cystic space is lined by a thin epithelial layer consisting of. In the present article, we report the clinical and histopathological features of a large, benign eccrine acrospiroma located on the left gluteal region in a 50yearold woman.
Poroma containing prominent ductal lumina are known as dermal ductal tumour. Soepronos textbook is available on and includes detailed information on over 600 entities and includes four dvd diskettes with highresolution images that provide a virtual dermatopathology reference and guide. Eccrine poroma was first reported by pinkus in 1956 and represents 10% of all sweat gland tumors. Acrospiroma diseasefinding, acrospiroma, eccrine, eccrine acrospiromas expand a benign epithelial neoplasm arising from the sweat glands. Eccrine hidrocystoma of skin is a rare condition in which there is a dilated cyst of the eccrine sweat glands. Pathology revealed dermal appendage neoplasm acrospiroma of hydra. Webpathology is a free educational resource with 10308 high quality pathology images of benign and malignant neoplasms and related entities. A cystic space occupies the dermis which may be unilocular figure 1. Helwig, in 1979, first described it as eccrine acrospiroma. It presents as a nodular lesion usually in the scalp, trunk, and proximal extremities. Background syringoid eccrine carcinoma sec is a rare malignant adnexal tumour with variable presentations. Pdf eccrine acrospiroma are benign skin tumours of sweat duct origin. Chapter 1 introducton histopathology definition it is a branch of pathology which deals with the study of disease in a tissue section.
There is perhaps eosinophilic proteinaceous contents here although it is poorly defined arrows 5. 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. A malignant acrospiroma is a sweat gland carcinoma of the hand, which may recur locally in 50% of patients after excision, with distant metastases occurring in 60% of patients. Clear cell hidradenoma, solid and cystic hidradenoma or dermal acrospiromas. Abstract three hundred and nineteen examples of a histologically distinctive sweat gland tumor, the acrospiroma, are presented. Another name for tumors that were previously believed to strictly derive from specific sweat gland types may, in fact, derive from both eccrine or apocrine glands. Eccrine acrospiroma american cancer society journals. In eccrine spiradenocarcinoma, sections show areas of benign eccrine spiradenoma with an abrupt transition in morphology figures 1, 2. Cytological features of malignant eccrine acrospiroma presenting as. Histology page 1 histological techniques histology is the study of the cellular organization of body tissues and organs. We read with interest the report by alnafussi and coworkers. A hidradenoma, here a benign neoplasm of the sweat glands of the cheek.
The tissue undergoes a series of steps before it reaches the examiners desk to be thoroughly examined microscopically to arrive at a particular diagnosis. Eccrine hidrocystoma is a cystic lesion, thought to be derived from cystic retention of native eccrine glands. The sections show hair bearing skin with a cyst lined by a bland bilayered epithelium. The histopathological differential diagnosis generally includes other tumors with.
This shows a photo of the secretory portion of the sweat glands at higher magnification. Eccrine acrospiroma, or hidradenoma, is a rare benign tumor of the sweat gland that typically is located in the superficial and deep dermis and occasionally in the subcutaneous tissue. The ducts are lined by stratified 2 layers cuboidal epithelium. Aggressive digital papillary adenocarcinoma at atypical site. Later, it was confirmed by histopathology to be a malignant eccrine accrospiroma. Eccrine acrospiromas are distinct sweat gland tumours that present as solitary plaques, nodules, orexophytic papules. The classic description features a cystic cavity number 1 with lightly eosinophilic staining material in the center.
Pigmented nodular hidradenoma masquerading as nodular malignant melanoma. Clinicopathological evaluation of clear cell hidradenoma. Eccrine spiradenocarcinoma is a rare sweat gland tumour. Recent analysis suggests that poromas can be of either eccrine or apocrine lineage. Mr imaging appearance of plantar eccrine acrospiroma. Eccrine and apocrine sweat gland tumors are believed to constitute as few as 1% of primary cutaneous lesions. Eccrine poroma definition of eccrine poroma by medical. This entity has been challenged by some authorities who regard these as having an apocrine origin. The final histologic diagnosis was benign eccrine acrospiroma. Solitary, nodule often partly solid, partly cystic.
Eccrine acrospiroma are benign skin tumours of sweat duct origin. Hidradenomas are called generally by definition benign. Aim to examine the clinicopathological and immunohistochemical features of sec. Clinicians reports dermoscopy of eccrine acrospiroma masquerading as nodular malignant melanoma acta dermatoven apa vol 19, 2010, no 4 dermoscopy of eccrine acrospiroma masquerading as nodular malignant melanoma a. Although various eccrine sweat gland tumours including benign acrospiroma are.
The tumor arises from eccrine glands, a type of sweat gland that is distributed throughout the body. A relatively rare tumor, poroma comprises approximately 10% of these lesions. Erythematous to violaceous ulcerative or exophytic firm nodule commonly located on the extremities, trunk, head, and neck of femalesmales in the 6th to 8th decade. Acrospiroma is a cutaneous condition, primarily occurring in adult women, that is a form of benign adnexal neoplasm closely related to poroma. A case report usha ku burra md, avninder singh md, sunita saxena md dcp dermatology online journal 11 2. Also known by various other names such as nodular hidradenoma, eccrine acrospiroma, and solid cystic hidradenoma. In our case, we present a 46 yearold female with a recurring exophytic tumor on the right lower extremity, without local extension. Large eccrine acrospiromas may foster concerns of malignancy, but malignant eccrine acrospiromas are rare usually of moderate size. Dermal pathology branch, armed forces institute of. Benign acrospiroma has been described under various names, including clear cell hidradenoma, clear cell myoepithelioma, solid cystic hidradenoma, nodular hidradenoma, basal cell carcinoma of sweat gland origin, clear cell papillary carcinoma, dermal sweat gland tumor, eccrine sweat gland adenoma of. Aggressive digital as the name suggests is a malignancy that has a metastatic potential with a tendency to. Also known by various other names such as nodular hidradenoma, eccrine acrospiroma. But the tendency, nowadays is to classify all forms as poroma.
Trevisan eccrine acrospiroma, better known as eccrine poroma, is a benign adnexal neoplasm of the skin. Acrospiroma represents a group of benign ductal tumors of the eccrine sweat glands that sometimes are connected to the skin, ranging from solitary plaques to exophytic papules or dermal nodules. It is an uncommon tumor that occurs on the skin as a painless nodule there are three different types of sweat glands in the skin. Pdf large eccrine acrospiroma of the hand researchgate. The term is derived from the greek histos meaning web or tissue, and refers to the science of tissues. Eccrine acrospiroma clear cell hidradenoma histopathology. Malignant forms of this tumour do exist and malignant transformation of a preexisting benign eccrine acrospiroma has been reported.
Their malignant transformations and metastasis are seen very rarely 3. Malignant eccrine acrospiroma with nodal and bone metastasis. Acrospiroma represents a group of benign ductal tumors. Eccrine acrospiroma symptoms, diagnosis, treatments and. The result of their study of 20 cases of eccrine spiradenoma demonstrated similarity both histologically and immunohistochemically between the epithelial cells of eccrine spiradenoma and the normal cells lining the eccrine apparatus. Hidradenoma is a cutaneous, often benign tumour of the sweat glands. More detailed information about the symptoms, causes, and treatments of eccrine acrospiroma is available below. Pdf nodular hidradenoma is a benign cutaneous neoplasm originated from ducts. Most of the eyelid tumors are of cutaneous origin, mostly epidermal, which can be divided into epithelial and melanocytic tumors. Eccrine carcinoma is an extremely rare malignancy of the skin with few well documented cases reported in the literature. This tumors incidence has been reported to be 6% of all the eccrine gland carcinomas 2. The tumor can occur anywhere on the body but is most common in the head, neck, arms and legs. Soeprono teaches and practices dermatopathology at loma linda university, school of medicine, department of dermatology.
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. Histopathology nested or in diffuse nested or in diffuse sheetssheets clear cells with centrally clear cells with centrally placed nucleiplaced nuclei increased increased vascularityvascularity. The tumor usually presents as a solitary painless papule or nodule, with a slow growing course, on the head, trunk or distal extremities. In veterinary literature database, the malignant form of tumor has been defined as an unique report in four dogs 4. The predominant lining cell has moderate pale grey cytoplasm and a small round nucleus.
In1969,johnson and helwig introduced the termeccrine acrospiroma to define a cutaneous neoplasm that had been previously reported under a variety of terms, for example eccrineporoma which was described first in 1956 by. Long thin myoepithelial cells are arranged helically around the periphery between the secretory. It typically arises within a preexisting eccrine spiradenoma that has been present for many years. Histopathology low power low power circumscribedcircumscribed nodules and cysts with nodules and cysts with possible epidermal possible epidermal attachmentattachment. Mc, usn dermal pathology branch and the registry of dermal pathology, armed forces institute of pathology, washington, d. It is frequently found on the lower extremities, and it equally affects both sexes in the sixth and seventh decade. Those which are confined exclusively to the dermis or have minimal connection to the epidermis are termed as dermal acrospiroma or hideradenoma 6. Arises from sweat gland distal excretory duct, usually solitary, on the scalp, axillae.