Clear cell hidradenoma is an uncommon benign skin appendageal tumor that typically involves the dermal layer of the head, face, and extremities. The breast is a rare site for this lesion, with only two documented cases, which were determined based on mammogram and sonogram findings. We present a case of clear cell hidradenoma of the axillary tail with radiological findings and a literature review.
Adenoma, Sweat Gland/pathology/*radiography/*ultrasonography ; *Axilla ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Middle Aged ; Sweat Gland Neoplasms/pathology/*radiography/*ultrasonography ; Ultrasonography, Doppler

Eccrine spiradenomas are rare, benign, cutaneous tumors that originate in the sweat glands. Eccrine spiradenomas in the breast are very rare and only a few cases have been reported. We report here on the case of a 47-year-old woman with superficial masses in the breast and these masses had gradually increased in size during follow-up. They were confirmed to be an eccrine spiradenoma on pathologic examination. There have been a few reports about the radiologic findings of eccrine spiradenomas of the breast. This is the first case of an eccrine spiradenoma in the breast that was characterized by multiple imaging modalities, including mammography, ultrasonography and MRI. The lesion in our patient was first diagnosed as an epidermal inclusion cyst based on the imaging findings and the mass's superficial location. Although the mammographic and ultrasonographic imaging findings of eccrine spiradenomas and epidermal inclusion cysts are similar, the MRI findings are different between epidermal inclusion cysts and eccrine spiradenomas. Eccrine spiradenomas should be considered in the differential diagnosis of cutaneous and subcutaneous lesions of the breast.
Adenoma, Sweat Gland/*diagnosis/pathology ; Biopsy, Needle ; Diagnosis, Differential ; Diagnostic Errors ; Epidermal Cyst/diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Skin Neoplasms/*diagnosis/pathology ; Sweat Gland Neoplasms/*diagnosis/pathology ; Ultrasonography, Mammary

A 79-year-old male presented with left ocular pain. Evisceration and silicone ball implantation were performed after a diagnosis of phthisis. He returned six weeks later because of left facial erythematous swelling, tenderness, mild fever, chills and cough. His condition was diagnosed as orbital cellulitis. Despite two weeks of empirical antibiotic therapy, the symptoms worsened. A subsequent orbital computed tomography scan revealed enhanced soft tissue infiltrations in his left orbit and eyelid. Biopsy showed a diffusely infiltrating tumor of signet ring cell cytology. A systemic evaluation revealed multiple bone metastases. Based on this evidence, the patient was diagnosed with a very rare case of histiocytoid variant eccrine sweat gland carcinoma with multiple bone metastases.
Aged ; Carcinoma/*diagnosis/pathology ; *Eccrine Glands ; Histiocytes/*pathology ; Humans ; Male ; Orbital Neoplasms/*diagnosis/pathology ; Positron-Emission Tomography ; Sweat Gland Neoplasms/*diagnosis/pathology ; Tomography, X-Ray Computed

OBJECTIVETo investigate the clinicopathological features and the differential diagnosis of poroma and porocarcinoma.

METHODSHistopathological characteristics and clinical data of 35 cases of poroma and 10 cases of porocarcinoma were analyzed retrospectively.

RESULTSThe average age of 35 patients of poroma was 48 years. The average age of 10 patients of porocarcinoma was 65 years. Both poroma and porocarcinoma occured most frequently on the scalp and face,as well as the extremities. Histologically, cases of poroma were divided into three subtypes, including classic poroma (23 cases), hidroacanthoma simplex (3 cases) and dermal duct tumor (9 cases). Residual foci of benign poroma were found in all cases of porocarcinoma, most of which were classic poroma. The malignant components showed severe dysplasia and/or stromal infiltration.

CONCLUSIONThe diagnosis of poroma and porocarcinoma is mainly based on the microscopic characteristics. An invasive architectural pattern and/or significant cytologic pleomorphism are the most important clues for the diagnosis of porocarcinoma. Neither focal mitotic activity nor the presence of necrosis was the diagnostic feature of porocarcinoma. Malignant transformation can occur in some cases of long existing poroma with recent, rapid tumor enlargement.

Aged ; Cell Transformation, Neoplastic ; Diagnosis, Differential ; Eccrine Porocarcinoma ; pathology ; Extremities ; Head and Neck Neoplasms ; pathology ; Humans ; Middle Aged ; Poroma ; pathology ; Retrospective Studies ; Scalp ; Skin Neoplasms ; pathology ; Sweat Gland Neoplasms ; pathology

Acanthoma ; metabolism ; pathology ; surgery ; Adenoma ; metabolism ; pathology ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Keratosis ; metabolism ; pathology ; surgery ; Male ; Poroma ; classification ; metabolism ; pathology ; surgery ; Sweat Gland Neoplasms ; classification ; metabolism ; pathology ; surgery

OBJECTIVETo investigate the pathologic and immunohistochemical features, diagnosis and differential diagnosis of low-grade adenosquamous carcinoma of the breast and syringomatous adenoma of the nipple.

METHODSSix cases of low-grade adenosquamous carcinoma of the breast and four cases of syringomatous adenoma of the nipple were examined histologically and immunohistochemically (MaxVision method), and the literature was reviewed.

RESULTSThe two types of tumors were similar in morphology, but located in different regions with low-grade adenosquamous carcinoma being present in the deep parenchyma and syringomatous adenoma in nipple. Both types of tumors were composed mainly of well-differentiated glands with angulated, comma shaped or polliwog appearance in a disordered infiltrative pattern. The tumor cells also formed solid tubules, strips or nests, with frequent areas of squamoid differentiation. Mitosis was rare. The interstitial tissue showed abundant spindle cells or sclerotic fibrosis with mixed inflammatory cells infiltration. One case of low-grade adenosquamous carcinoma showed a concomitant malignant adenomyoepithelioma, and another case showed concomitant spindle cell metaplastic carcinoma. One case of syringomatous adenoma involved the deep parenchyma. Immunohistochemistry of low-grade adenosquamous carcinoma showed that CK5/6 and p63 were positive in the outer layer of the glands and the squamoid epithelium, and CD10 was also positive in the outer layer of the glands. ER and HER2 were negative, and PR was also negative except for one case in which the spindle cells were positive for CK5/6, AE1/AE3 and PR focally. Immunostaining of syringomatous adenoma demonstrated that p63 and CK5/6 were positive in the outer layer of the glands and the squamoid epithelium. Calponin, SMA, ER, PR and HER2 were all negative.

CONCLUSIONSLow-grade adenosquamous carcinoma of the breast and syringomatous adenoma of the nipple are similar in morphology and immunohistochemical phenotype, while the biological features are opposite due to different locations. The differential diagnoses include tubular carcinoma, adenosquamous carcinoma, radial sclerosing lesions and others.

Adenocarcinoma ; pathology ; Adult ; Aged ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; metabolism ; pathology ; Carcinoma, Adenosquamous ; diagnosis ; metabolism ; pathology ; Carcinoma, Squamous Cell ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Middle Aged ; Neprilysin ; metabolism ; Nipples ; pathology ; Sclerosis ; Sweat Gland Neoplasms ; diagnosis ; metabolism ; pathology ; Syringoma ; diagnosis ; metabolism ; pathology ; Transcription Factors ; metabolism ; Tumor Suppressor Proteins ; metabolism