ABSTRACT
Objective To analyze clinicopathologic features and malignant transformation of spiradenoma (SA).Methods Clinicopathologic data on 25 cases of SA were retrospectively analyzed.An immunohistochemical study was conducted on 5 of the 25 patients.Clinicopathologic features of SA were summarized based on clinicopathologic data,immunohistochemical results and relevant literature.Results The average age of these patients was 40 years.Lesions were acquired and solitary in 24 cases (96％,24/25),and occurred most frequently in the extremities.The diameter of tumors was less than 2 cm in 20 cases (87％,20/23).Twenty-three cases were benign SA with various histological manifestations,including 15 cases (65％,15/23) of typical SA,8 cases (35％,8/23) of cylindroma.VarTing numbers of mitotic figures were observed in different cases.The immunohistochemical study showed epithelial and myoepithelial differentiation.Two cases of SA experienced malignant transformation into poorlydifferentiated basal cell adenocarcinoma and well-differentiated adenocarcinoma respectively.Lymphocytes decreased significantly in number or disappeared in the malignant area,and both the malignant tumors exceeded 2 cm in diameter.Conclusions SA is a kind of neoplasm with distinct histological characteristics and nonspecific clinical manifestations.Most SA cases have a benign clinical course,but malignant transformation should be considered in some cases with longterm clinical course and large size.
ABSTRACT
A 70-year-old female patient presented with several cutaneous masses on the left neck and trunk for 40 years. Some masses were removed by surgical operation more than 10 years prior to the presentation, but recurred subsequently along with an increase in lesion number. Persistent dull pain emerged at the lesion sites 2 months prior to the presentation and the masses on the left neck ulcerated 10 days prior to the presentation. Histopathology showed tumor cell clumps in the dermis with benign eccrine spiradenoma components in the centre region and carcinomatous components in the periphery. The carcinomatous components included slightly atypical cells and hyaline degeneration. Immunohistochemically, carcinoembryonic antigen and epithelial membrane antigen were observed in the tumor tissues. The case was diagnosed as eccrine spiradenocarcinoma. The masses were surgically removed, but recurred 1 month later, increased in size and number and ulcerated 3 months later, and the patient died 6 months after the surgery.