Apocrine hidrocystoma of the cheek.

BACKGROUND: Apocrine hidrocystoma is an uncommon benign cystic proliferation of the apocrine sweat glands. Malignant melanoma, eccrine hidrocystoma, angioma, and follicular cysts have to be considered as differential diagnoses. METHODS AND RESULTS: A 63-year-old man is presented with a dark mass measuring 2 x 2 cm on his right cheek. An exocrine tumor or, more unlikely, a melanoma was considered as a differential diagnosis. Pathologically, the lesion was determined to be an apocrine hidrocystoma. CONCLUSIONS: This benign lesion can be excised by a narrow margin. Therefore, knowledge of this benign entity in head and neck surgery including the differential diagnosis can prevent an unnecessarily large defect by too large margins.

Mucosal malignant melanomas in head and neck surgery: a retrospective study of six patients and review of the literature.

INTRODUCTION: Of all malignant processes of the oral mucosa, 0.5% are malignant melanomas. Because of late diagnosis, pattern of growth, close proximity to the bone (particularly in palatinal localizations), and the correlated infiltration, malignant melanomas have a bad prognosis. PATIENTS AND METHODS: In this retrospective study, six cases of patients with oral mucosal malignant melanoma are evaluated, and a critical review of the literature is presented. The female to male proportion was 1:1 with an average age of 60.2 years; all patients were treated between January 1999 and July 2007. A neck dissection was performed on two patients because of clinically positive lymph nodes; one patient received interleukin 2 therapy, and three patients received postoperative radiotherapy. Two male patients died. CONCLUSIONS: We recommend biopsy on every growing lesion, pigmented or nonpigmented, for the required diagnosis and, in cases of malignant melanoma, wide excision as a second step. Neck dissections should be performed in patients with clinically positive lymph nodes. Concerning interleukin 2 therapy, further studies should be performed in order to evaluate a routine application.