A Clinical Experience of Malignant Nodular Hidradenoma in Face

ABSTRACT

Sweat gland carcinoma is the uncommon neoplasm, with few cases reported in the literatures. In a review of literatures, the most commonly used term is malignant nodular hidradenoma; however, similar cases also have been known as a malignant clear cell hidradenoma, malignant clear cell myoepithelioma, clear cell eccrine carcinoma and malignant clear cell acrospiroma. It is difficult to differentiate clinically between sweat gland carcinomas and other skin lesion, such as keloids, sebaceous cyst, dermatofibroma, lymphoma, and squamous cell carcinoma. Thus, a preoperative diagnosis of sweat gland carcinoma is rarely made and histologic examination is the only means of diagnosis. Most sweat gland carcinomas are found on the scalp, face, upper extremities, and axilla. The lesions are typically small, very slow growing, painless nodules. However, it is aggressive, infiltrative, and has highly recurrent rate. Lymph node metastases are frequent and overall survival is poor. So, that must be treated with wide local excision of the lesion and primary regional node dissection is recommended.We have experienced of a case of malignant nodular hidradenoma in cheek area. It was widely excised by total parotidectomy and covered by scapula fasciocutaneous free flap. We report this case with the review of the literature.