ABSTRACT
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ABSTRACT
Malignant transformation of hidroacanthoma simplex into in situ porocarcinoma, also known as hidroacanthoma simplex with invasive growth, is very rare. Malignant hidroacanthoma simplex generally arises in the elderly and occurs most frequently on the lower extremities and trunk. The gross appearance of the tumor tends to vary, and there are nodular lesions or keratotic plaques with or without erosion and/or ulceration. In some cases, it clinically resembles Bowen's disease or seborrheic keratosis. Histopathologically, the tumor appears similar to hidroacanthoma simplex, but the cells are atypical with hyperchromatic nuclei, and many are in mitosis. Here we report an extremely rare case of malignant hidroacanthoma simplex that occurred on the right knee of an 84-year-old Korean woman.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Bowen's Disease , Keratosis, Seborrheic , Knee , Lower Extremity , Mitosis , UlcerABSTRACT
Eccrine porocarcinoma is a rare cutaneous neoplasm arising from the eccrine sweat duct. It may arise de novo or evolve from a pre-existing poroma or hidroacanthoma simplex. The pigmented variant of porocarcinoma is very rare, and its heavy pigmentation can lead to misdiagnosis of seborrheic keratosis or melanoma. An 82-year-old male patient presented with a painful, brown-to-black colored plaque measuring 4x4.5 cm with a central pedunculated nodule that measured 2.5x2 cm on his right posterior thigh. A small, pigmented papule had developed 10 years prior and had gradually increased in size. Histopathologic examination of the nodule revealed lobulated tumor islands composed of atypical basaloid cells in the periphery, eosinophilic squamous cells in the center, and pigmented dendritic cells scattered throughout nests of the tumor. Carcinoembryonic antigen and epithelial membrane antigen were expressed in the tumor cells and the dendritic cells stained positive for S-100 and HMB45. Histopathologic findings from the plaque showed many pigmented nests embedded within the epidermis that were composed of small, polygonal, pigmented basaloid cells. Pigmented eccrine porocarcinoma arising from pigmented hidroacanthoma simplex was diagnosed clinically and histopathologically. The tumor was completely excised. We report a case of pigmented porocarcinoma, which should be included among clinically important differential diagnoses apart from melanoma.
Subject(s)
Aged, 80 and over , Humans , Male , Carcinoembryonic Antigen , Dendritic Cells , Diagnosis, Differential , Diagnostic Errors , Eccrine Porocarcinoma , Eosinophils , Epidermis , Islands , Keratosis, Seborrheic , Melanoma , Mucin-1 , Pigmentation , Poroma , Sweat , ThighABSTRACT
BACKGROUND: Poroid neoplasms consist of classic poroma, hidroacanthoma simplex, dermal duct tumor, and poroid hidradenoma. Poroid neoplasms are not rare tumors in dermatology. However, studies of the clinicopathologic characteristics of poroid neoplasms in Korea are very limited. OBJECTIVE: To investigate the clinicopathologic characteristics of poroid neoplasms in Korea. METHODS: The clinicopathologic characteristics of forty three cases of poroid neoplasms were retrospectively analyzed. RESULTS: Poroid neoplasms were diagnosed mostly in the sixth decade, without sex predominance. The most common site was the lower extremities, followed by the head & neck, the trunk, the sole, the palm, and the upper extremities. All cases were observed as a solitary lesion. Papule or nodule shape, verrucous surface, and erythmatous color were most common characteristics of poroid neoplasms. The two cases showed sebaceous differentiation. Some cases showed melanin pigmentations in the lesions or perilesional basal layer. CONCLUSION: Our study will be a resourceful data of poroid neoplasms for dermatologists and pathologists.
Subject(s)
Acrospiroma , Dermatology , Head , Korea , Lower Extremity , Melanins , Methylmethacrylates , Neck , Pigmentation , Polystyrenes , Poroma , Retrospective Studies , Upper ExtremityABSTRACT
Hidroacanthoma simplex is a rare, benign intraepidermal skin tumor originating from eccrine ducts. It usually develops on the lower extremity or trunk of the elderly, and appears as a well-demarcated brownish to erythematous flat or verrucous plaque. It is often clinically misdiagnosed as seborrheic keratosis or Bowen's disease and the pathogenesis of the disease is not understood. Histopathologically, it shows characteristic intraepidermal nests not extended to the dermis, the so called Borst-Jadasshon phenomenon. The nests are composed of uniform cuboidal tumor cells with a round, basophilic nucleus. Here we report a case of hidroacanthoma simplex following burn injury in an 82 year-old woman.
Subject(s)
Aged , Female , Humans , Basophils , Bowen's Disease , Burns , Dermis , Keratosis, Seborrheic , Lower Extremity , Methylmethacrylates , Polystyrenes , SkinABSTRACT
PURPOSE: Hidroacanthoma simplex (HAS) is a rare benign neoplasm of the skin and known as intraepidermal poroma. Malignant transformation of HAS has been reported in the literature, but it is very rare. We experienced a case of malignant hidroacanthoma simplex (MHA) and performed the surgery of the neoplasm. METHODS: A 73-year-old patient visited our department for evaluation and treatment of the skin lesion (3.2 x 3.0 cm2) that occurred two years before on the right ankle area. The lesion was characterized by dark-brown, hyperkeratotic and protruding patch. The patient had no symptom, and any palpable lymph node was not found on physical examination. The result of laboratory was also nonspecific. The lesion was excised completely with a resection margin of 5 mm including subcutaneous tissue partially, followed by full-thickness skin graft for reconstruction. RESULTS: The result of biopsy was reported as malignant hidroacanthoma simplex. Histologically, the epidermis showed discrete aggregates of tumor cells which had round, hyperchromatic nuclei and pale or clear abundant cytoplasm. Cystic spaces were found within the tumor and mitosis were seen, frequently. No recurrence was found one month after surgery. CONCLUSION: The case of malignant hidroacanthoma simplex was treated with full-thickness skin graft following wide excision of the tumor.
Subject(s)
Aged , Animals , Humans , Ankle , Biopsy , Cytoplasm , Epidermis , Lymph Nodes , Methylmethacrylates , Mitosis , Physical Examination , Polystyrenes , Poroma , Recurrence , Skin , Subcutaneous Tissue , TransplantsABSTRACT
PURPOSE: Hidroacanthoma simplex (HAS) is a rare benign neoplasm of the skin and known as intraepidermal poroma. Malignant transformation of HAS has been reported in the literature, but it is very rare. We experienced a case of malignant hidroacanthoma simplex (MHA) and performed the surgery of the neoplasm. METHODS: A 73-year-old patient visited our department for evaluation and treatment of the skin lesion (3.2 x 3.0 cm2) that occurred two years before on the right ankle area. The lesion was characterized by dark-brown, hyperkeratotic and protruding patch. The patient had no symptom, and any palpable lymph node was not found on physical examination. The result of laboratory was also nonspecific. The lesion was excised completely with a resection margin of 5 mm including subcutaneous tissue partially, followed by full-thickness skin graft for reconstruction. RESULTS: The result of biopsy was reported as malignant hidroacanthoma simplex. Histologically, the epidermis showed discrete aggregates of tumor cells which had round, hyperchromatic nuclei and pale or clear abundant cytoplasm. Cystic spaces were found within the tumor and mitosis were seen, frequently. No recurrence was found one month after surgery. CONCLUSION: The case of malignant hidroacanthoma simplex was treated with full-thickness skin graft following wide excision of the tumor.
Subject(s)
Aged , Animals , Humans , Ankle , Biopsy , Cytoplasm , Epidermis , Lymph Nodes , Methylmethacrylates , Mitosis , Physical Examination , Polystyrenes , Poroma , Recurrence , Skin , Subcutaneous Tissue , TransplantsABSTRACT
Hidroacanthoma simplex is a benign tumor believed to arise from the uppermost segment of the intradermal eccrine duct and the acrosyringium, and histologically shows intraepidermal focal growth. A malignant counterpart to this tumor is rare and named malignant hidroacanthoma simplex or porocarcinoma in situ. We report a case of atypical hidroacanthoma simplex, which is considered to be a malignant transformation of benign hidroacanthoma simplex in a 83- year-old female.
Subject(s)
Female , Humans , ImmunohistochemistryABSTRACT
Hidroacanthoma simplex, eccrine poroma and dermal duct tumors have recently come to be viewed as variants of benign poroid neoplasia, due to their similar histopathologic and cytologic features. Some authors have reported the association of two or three of these tumors in a single lesion. We herein report a patient with two subtypes of poroma in a single lesion.
Subject(s)
Humans , PoromaABSTRACT
Hidroacanthoma simplex is a rare skin tumor which most often develops on the lower extremity of an elderly person. Clinically, the lesion appears as a well-demarcated brownish flat or verrucous plaque, resembling seborrheic keratosis or Bowen's disease. Histologically, it is characterized by intraepidermal nests of basaloid cells within an acanthotic epidermis. there is some controversy over the histogenesis of hidroacanthoma simplex, many consider it an epidermal tumor differentiation into intraepidermal eccrine duct cells. We report a case of hidroacanthoma simplex presented a small verrucous papule on the left foot with the results of an immunohistochemical study.
Subject(s)
Aged , Humans , Bowen's Disease , Epidermis , Foot , Keratosis, Seborrheic , Lower Extremity , SkinABSTRACT
Hidroacanthoma simplex, eccrine poroma, and dermal duct tumor have all been reported as distinct neoplasms of eccrine sweat duct origin. However, these tumors have recently come to be viewed as variants of benign poroid neoplasia owing to their similar histopathologic and cytologic features. Some cases of two or three subtypes of poroid neoplasm coexisting in a single lesion have been reported in foreign countries. We report herein a 61-year-old female who visited our outpatient department due to an erythematous pedunculated mass on the left thigh. Histopathologic findings showed both poroid and cuticular cells, intercellular or intracytoplasmic ducts, and monomorphism of the nuclei of poroid and cuticular cells in all three neoplasms. This is the first case of a poroma composed of three histologically distinct lesions in a single lesion in Korea.
Subject(s)
Female , Humans , Middle Aged , Korea , Outpatients , Poroma , Sweat , ThighABSTRACT
Hidroacanthoma simplex (HS) is a rare benign intraepidermal tumor thought to originate from the intraepidermal eccrine duct. Many authors regard it as an intraepidermal form of eccrine poroma but there is still a discussion as to the histogenesis of HS. Clinically, it is more common in older adults and affects both sexes equally. It is found more often on the lower extremities and trunk. The clinical appearance is not characteristic, but the lesions are usually flat or slightly elevated verrucous brown plaques. Histopathologically, the tumor shows characteristic intraepidermal nests and is one of a number of cutaneous lesions showing Borst-Jadasshon phenomenon, that is, tendency to form nests within the epidermis. The tumor cells composing nests show a uniform cuboidal appearance and a round, deeply basophilic nucleus typically. The cytoplasm of tumor cell gives a positive PAS reaction that is diastase-labile. We report herein three cases of HS with the results of immunohistochemical studies.