SEBACEOMA : A RARE CASE REPORT CLINICALLY DIAGNOSED AS PLEOMORPHIC ADENOMA.

Sebaceoma is a benign tumour of epidermal appendages with sebaceous differentiation also known as sebaceous epithelioma .We report a case of a 31 year old male presented with an exophytic mass on the posterior side of right ear lobule. Histopathology revealed rippled pattern sebeceoma comprising of cells arranged in sheets, cohesive nests and islands mostly comprising of basaloid cells (>50%)with mature sebocytes interspersed in between. The sebocytes appeared as clear cells , some cells multivacuolated with central indented nuclei. The rippled pattern sebeceoma is a histological variant and is seen predominantly in males in the head, neck and face region.The immunohistochemistry markers Epithelial Membrane Antigen (EMA) was focally positive along with Pan-Cytokeratin being strongly positive and diffuse which were con?rmatory for the disgnosis.

Embarazo y tumor anexial: tratamiento laparoscópico con minilaparotomía. Reporte de caso y revisión bibliográfica / Pregnancy and annexal mass; laparoscopic with minilaparotomy management. Case report and literature review

Resumen ANTECEDENTES: Los tumores anexiales durante el embarazo requieren una conducta terapéutica segura para la madre y el feto, por lo que el obstetra debe tener claro cuándo la opción quirúrgica es la indicada y cuál la menos agresiva para la madre y el feto. Describir la implementación de la laparoscopia con minilaparotomía en un caso de tumor anexial en el embarazo puede contribuir a conocer las ventajas y desventajas de la estrategia quirúrgica de estos casos. CASO CLÍNICO: Paciente de 29 años, 70 kg de peso, talla de 1.61 m e IMC 27 en curso de las 16 semanas de embarazo, que acudió al servicio de Urgencias debido a un dolor abdominal. Ante la persistencia del síntoma se estableció el diagnóstico de síndrome doloroso abdominal, secundario a un tumor anexial gigante. Se programó para una laparoscopia diagnóstica y operatoria con minilaparotomía. Se dio de alta del hospital a las 24 horas posteriores a la cirugía y el embarazo finalizó a las 39 semanas. METODOLOGÍA: Búsqueda retrospectiva de artículos publicados durante los últimos diez años e indizados en la base de PubMed con los MeSH: adnexal masses pregnancy, adnexal masses pregnancy and laparoscopic surgery. RESULTADOS: Se incluyeron 34 artículos de revisión, 8 reportes de caso y un editorial, estos últimos 9 se consideraron cuando proveyeron información relevante para el conocimiento de una técnica quirúrgica. Se eliminaron los artículos en los que se utilizó cirugía asistida por robot o técnica con uso de orificios naturales (NOTES), revisiones que fueran exclusivas de patología oncológica, así como casos en niñas, al no disponer de esta tecnología en nuestro medio o no estar en etapa reproductiva, podría incurrirse en un riesgo de transferencia. Así mismo, se eliminaron los artículos sin explicación de las ventajas de la técnica propuesta. CONCLUSIÓN: En pacientes embarazadas con tumor anexial gigante, la laparoscopia con minilaparotomía es una opción de tratamiento segura para el feto y la madre. Con esta técnica se consigue una rápida recuperación, disminución de los riesgos de lesión uterina, pronta reintegración a la vida cotidiana y un buen desenlace cosmético.

Abstract BACKGROUND: Adnexal tumors during pregnancy require safe therapeutic behavior for the mother and the fetus, so the obstetrician must be clear when the surgical option is indicated and within the approach which would be less aggressive for the fetal-maternal binomial. Describing the implementation of laparoscopy with mini laparotomy in a case of adnexal tumor in pregnancy can contribute to understanding the advantages and disadvantages of the surgical strategy in these cases. CLINICAL CASE: Patient aged 29 years, weight 70 kg, height 1.61 m and BMI 27 in the course of 16 weeks of pregnancy, who attended the emergency department due to abdominal pain. Given the persistence of the symptom, a diagnosis of painful abdominal syndrome secondary to a giant adnexal tumour was established. She was scheduled for diagnostic and operative laparoscopy with mini-laparotomy. She was discharged from hospital 24 hours after surgery and the pregnancy ended at 39 weeks. METHODOLOGY: A literature search of the last 10 years was performed in Pubmed under the MeSH terms: adnexal masses pregnancy, adnexal masses pregnancy and laparoscopic surgery. RESULTS: Thirty-four review articles, eight case reports and one editorial were included, the latter nine were considered when they provided information relevant to the knowledge of a surgical technique. We eliminated articles in which robot-assisted surgery or a technique using natural orifices (NOTES) was used, reviews that were exclusive to oncological pathology, as well as cases in girls, as this technology was not available in our environment or they were not in the reproductive stage, which could incur a risk of transfer. Likewise, articles that did not explain the advantages of the proposed technique were eliminated. CONCLUSION: In pregnant patients with giant adnexal tumours, laparoscopy with mini-laparotomy is a safe treatment option for the foetus and the mother. This technique achieves a rapid recovery, reduced risk of uterine injury, early reintegration into daily life and a good cosmetic outcome.

ECCRINE SPIRADENOMA : CASE REPORT WITH AN UNUSUAL CLININAL PRESENTATION

Eccrine spiradenoma is one of the rare, benign dermal neoplasm showing eccrine sweat gland differentiation. The literature search accounts for less than 100 reported cases of eccrine spiradenoma. Clinically, the lesion presents as solitary, intradermal, circumscribed, round or oval, firm, painful or tender nodule measuring from 0.3 - 5 cm in diameter. Rarely if ES, presents as multiple lesions, in combination with other types of adnexal tumors such as cylindromas & trichoepitheliomas, it can be considered as a part of the Brooke-Spiegler syndrome. Majority of these tumours appear on the head/face & upper trunk region of the body. Spiradenomas arise in early adulthood in most instances with few reports also of congenital cases and no sex predilection seen. The definitive diagnosis is made by excisional biopsy of the tumour. Complete tumor excision with clear surgical margins is considered the primary treatment for these cases. Here, we present a rare case report of a 58 years old male presenting with a soft, cystic lesion in the left lumbar region of the abdomen for past 2 years duration. Surgical excision of the tumour was done with clear margins and the specimen was sent for histopathological examination. Due to the overlapping histomorphological features, this tumour is often confused with cylindromas and trichoepitheliomas along with other vascular tumours. Eccrine Spiradenoma, although a benign tumour, but malignant transformation has been described especially in long-standing cases or multiple lesions. So, early diagnosis is very important to prevent recurrence and to identify any onset of malignant transformation

Dermoscopy of Dilated Pore of Winer

Summary@#Dilated pore of Winer is a benign adnexal tumour of follicular differentiation. It has typical clinical feature of asymptomatic, solitary enlarged pore with a keratin plug. Dermoscopy offers further assistance in diagnosis. In this case on dermoscopy, well defined lamellated central blackish area arranged in concentric circles, surrounded by a bluish grey halo was seen with a rim of hyperpigmentation.

Yellow nail syndrome and adnexal tumour: Causal or casual association.

The yellow nail syndrome is an uncommon condition characterised by dystrophic nails, pulmonary disturbances and lymph oedema. In Brazil as well as in India, this syndrome has been scarcely described, at least in part due to diagnosis pitfalls related with darker skin pigmentation. A case of adnexal malignancy developing several decades after initial signs of yellow nail syndrome is reported in a 61-year-old Brazilian female admitted for evaluation of peripheral oedema. She reported recurrent sinusitis and bronchitis, and three antecedent pneumonias. Physical examination showed yellow thickened nails and lower limb oedema, and a painless huge adnexal mass. Diverse tumours have been described associated with yellow nail syndrome; however, associations can also occur by chance. The present report attempts to raise the awareness about casual co-existence of malignancy and the syndrome.

Siringocistoadenomas papilíferos: descripción de dos casos / Syringocystadenoma papilliferum: report of two cases

El siringocistoadenoma papilífero es un raro tumor anexial benigno de naturaleza ecrina o apocrina; o seade histogénesis incierta. Es un tumor de la niñez y adolescencia con muchos ejemplos descritos en el momento del nacimiento. Se asocia a un nevo sebáceo pre-existente en el 30% de los casos. Su diagnóstico es netamente histológico y el tratamiento quirúrgico es curativo.

Syringocystadenoma papilliferum is a rare benign adnexal of eccrine or apocrine nature; uncertain histogenesis. It is a tumour of childhood or adolescence, with many examples noted at birth. The neoplasmoccurs in association with an organoid naevus such as naevus sebaceous in at least one-third of cases. Itsdiagnosis is purely histological and simple excision is curative.