ABSTRACT
RESUMEN Objetivo : Presentación de un caso, consistente en una lesión tumoral, compatible con hidradenocarcinoma, desarrollado en un paciente joven, y revisión de la literatura referida a la entidad mencionada. Métodos : Se valora en el servicio de dermatología un paciente de 17 años con una lesión de crecimiento progresivo, localizada en tercio medio de la pierna derecha, la cual a la inspección muestra secreción hialina y sangrado, manifestando prurito como síntoma ocasional, al inicio de la lesión. Se decide tomar biopsia de la lesión para confirmar diagnóstico. Resultados : Se hace diagnóstico clínico e histopatológico de hidradenocarcinoma siendo este un tumor raro maligno, originado en glándulas sudoríparas que se localiza cualquier parte del cuerpo, el cual en la mayoría de los casos se ha descrito como de origen ecrino. Conclusiones : Aunque no es una patología frecuente tiene altas tasas de recurrencia y riesgo de metástasis. Por lo tanto, es importante considerarla siempre como uno de los diagnósticos diferenciales, y de esa manera ofrecer un oportuno tratamiento quirúrgico, con márgenes amplios de resección.
SUMMARY Objective : Presentation of a case report, consisting of a tumor lesion, compatible with hydradenocarcinoma, developed in a young patient, and review of the literature referring to the mentioned entity. Methods : A 17-year-old patient with a progressive growth lesion, located in the middle third of the right leg, was evaluated in the dermatology service, which upon inspection showed hyaline secretion and bleeding, manifesting pruritus as an occasional symptom. A skin biopsy was performed to confirm the diagnosis. Results : A clinical and histopathological diagnosis of hydradenocarcinoma is made, this being a rare and malignant tumor originating in sweat glands that is located anywhere in the body, which in most cases has been described as of eccrine origin. Conclusions : Although it is not a frequent pathology, it has high recurrence rates and risk of metastasis. Therefore, it is important to always consider it as one of the differential diagnoses, and thus offer timely surgical treatment, with wide resection margins.
ABSTRACT
RESUMEN El Hidradenoma nodular maligno o Hidradenocarcinoma es un tumor poco frecuente, derivado de las glándulas sudoríparas ecrinas. Puede surgir de novo o por la transformación de su contraparte benigna. Estos tumores son de crecimiento lento, comportamiento agresivo, con alta incidencia de recurrencias y posibilidad de metástasis. Su prevalencia es en la población adulta, y su pronóstico, incierto. El tratamiento de elección de estos tumores es la escisión quirúrgica con márgenes amplios.
ABSTRACT The Malignant nodular Hydradenoma or Hydradenocarcinoma is a rare tumor, derived from the eccrine sweat glands, may arise de novo or by the transformation of its benign counterpart. These tumors are slow growing, aggressive behavior, with a high incidence of recurrences and the possibility of metastasis; its prevalence being in the adult population, and its prognosis is uncertain. The treatment of choice for these tumors is surgical excision with wide margins.
ABSTRACT
Malignant Nodular hidradenoma is an extremely rare aggressive tumour originating from eccrine sweat glands with an incidence of <.001%. So far less than 80 cases have been reported in the literature. It’s known for its local recurrence (50%) and metastasis (60%) and hence early diagnosis and radical treatment is mandatory. But differentiating it from its benign counterparts and other skin tumour mimics is challenging, due to its histopathological similarity & lack of diagnostic immunomarkers. Authors report a case of 65-year-old female who presented with a short 4-month history of rapidly growing ulceroproliferative growth in the right inguinal region with bilateral inguinal node enlargement, associated with pain and discharge. Wedge biopsy of left inguinal lymph node showed malignant cutaneous adnexal tumour deposits, which after excision was typed as malignant nodular hidradenoma. It was confirmed with immunohistochemistry. Patient presented with recurrence 8 months after excision.
ABSTRACT
Nodular hidradenocarcinoma was first reported as a clear-cell papillary carcinoma by Liu et al. in 1949. With a potential for uncontrollable local recurrence, it tends to metastasize and often causes death. We report a case of a 68-year-old man with nodular hidradenocarcinoma on the left preauricular area. Histopathology of the tumor showed a multilobulated intradermal mass. In the tumor nodule, there were many cystic spaces of various sizes, resulting from tumor necrosis. The tumor consisted of large, atypical, polygonal cells with eosinophilic cytoplasm, and clear cells with clear cytoplasm. Numerous mitoses were evident. We obtained positive results from an immunohistochemical study with antibodies to cytokeratins, epithelial membrane antigen, and PAS. The patient was treated with a wide local excision. However, we observed a recurrence one month later and performed a wide excision and local skin flap. There has been no evidence of recurrence or metastasis for six months after the second excision.
Subject(s)
Aged , Humans , Antibodies , Carcinoma, Papillary , Cytoplasm , Eosinophils , Keratins , Mitosis , Mucin-1 , Necrosis , Neoplasm Metastasis , Recurrence , SkinABSTRACT
Introducción: Las glándulas ecrinas (sudoríparas) se encuentran en todos los sitios de la piel y son más abundantes en las palmas de las manos y plantas de los pies. El hidradenocarcinoma nodular es un tumor raro de las glándulas ecrinas, maligno y agresivo. El objetivo de este trabajo es informar de un caso de hidradenocarcinoma perianal. Caso clínico: Mujer de 75 años de edad, diabética, hipertensa e hipotiroidea. Al examen físico se observó y palpó tumoración perianal pequeña que llegaba hasta canal anal; se tomó biopsia con resultado de hidradenoma perianal. Se llevó a cabo rectosigmoidoscopia hasta 25 cm, normal. Tomografía computarizada: adenopatías de 1 cm en región inguinal e iliaca derecha. Se realizó resección amplia de la tumoración. El informe de patología fue acrospiroma ecrino maligno. Actualmente la paciente se encuentra en tratamiento complementario con quimioterapia. Conclusiones: En pacientes que debuten con lesiones malignas metastásicas en región inguinal debe pensarse en origen del conducto anal.
BACKGROUND: Eccrine glands (sweat glands) appear in all sites of the skin and are more abundant in hands and feet. Nodular hidradenocarcinoma (NH) is a rare malignant and aggressive tumor of the eccrine glands. The objective of this study is to report a case of perianal hidradenocarcinoma. CLINICAL CASE: We present the case of a 75-year-old female with diabetes, hypertension, and hypothyroidism. Physical examination revealed a small perianal tumor that was palpated near the anal canal. Biopsy was done. Pathology report revealed perianal hidradenoma. Rectosigmoidoscopy was normal. Computed tomography showed 1-cm adenopathies in inguinal and right iliac regions. Extensive resection of the tumor was done. Definitive pathology report was malignant eccrine acrospiroma. The patient underwent adjuvant chemotherapy in the Oncology Service and died 1 month later. CONCLUSIONS: In patients with a first symptom of metastases in the inguinal region, suspicion must be directed to the anal canal.