1/23. Pigmented hidrocystoma of the eccrine secretory coil in the vulva: clinicopathologic, immunohistochemical and ultrastructural studies. A case of pigmented hidrocystoma of eccrine secretory coil is presented. A 47-year-old woman had developed a bluish black small nodule in the anterior portion of the labium minor a few years before entry. Microscopically, the cyst was lined by eosinophilic columnar epithelium with abundant brownish granules. There was a vague suggestion of decapitation secretion focally in the epithelial layer of cuboidal cells. This layer expressed distinct reactivity against CA19-9 with no reactivity for human milk fat globule-1 (HMFG-1). These features demonstrated that the cyst was not of apocrine nature but of eccrine derivation. In addition, positive immunoreaction for cytokeratin (CK)7, CK8 and CK19 defined the cyst as originating from the secretory coil of the sweat gland. Ultrastructurally, melanosomes in various stages were identified in most of the epithelial cells. These findings suggest that the present case was a hidrocystoma of eccrine secretory coil with abnormal melanin accumulation. ( info) |
2/23. Excision of multiple eyelid apocrine hidrocystomas via an en-bloc lower eyelid blepharoplasty incision. A 39-year-old man presented with upper and lower eyelid apocrine hidrocystomas that had recurred after each of three prior attempts at excision. These multiple, cystic tumors were adherent to the epidermis, thus precluding complete dissection and excision of each individual lesion. We report a surgical technique using a lower eyelid blepharoplasty incision to remove the confluent tumors of the lower eyelids en-bloc. We paid careful attention to both removing the lesions without rupturing the cysts and to achieving adequate depth of excision. histology revealed features typical of apocrine hidrocystomas. The patient has remained free of recurrence three years since the en-bloc excision of the lesions. ( info) |
3/23. The efficacy of electrosurgery and excision in treating patients with multiple apocrine hidrocystomas. BACKGROUND: Apocrine hidrocystomas are adenomatous cystic proliferations of the apocrine glands. They typically occur as solitary lesions, though rarely may occur as multiple lesions. Management of multiple hidrocystomas can be difficult, particularly if they are large. Surgical modalities may be required for effective therapy. OBJECTIVE: To compare the results of electrosurgery and excision in treating multiple apocrine hidrocystomas. methods: A 50-year-old man presented with multiple apocrine hidrocystomas ranging in size from 1 to 12 mm. The lesions were located over the periorbital skin, cheeks, and pinnae. Excision and electrodessication were utilized for therapy. At a 1-year follow-up, the patient was evaluated for recurrences and cosmetic result. RESULTS: There were no recurrences until 1 year after surgery. In the areas treated with electrodessication, no visible scars were identified. In the areas treated with excision, localized scars were observed. CONCLUSIONS: Both electrodessiation and excision are effective therapies for multiple apocrine hidrocystomas. We suggest that tumors less than 1 cm be treated with electrodessication and lesions greater than 1 cm with excision. ( info) |
4/23. Pulsed dye laser treatment of multiple eccrine hidrocystomas: a novel approach. BACKGROUND: Multiple eccrine hidrocystomas are benign cystic lesions that pose a significant treatment challenge due to their facial location and tendency to scar after traditional surgical and other destructive modalities. methods: A 585nm pulsed dye laser was used at fluences ranging 7.0 J/cm2 to 7.5 J/cm2 at 6- to 8-week intervals to treat multiple lesions on the face of a 54-year-old man. RESULTS: Near complete resolution of all papules was seen after four laser sessions. There was no evidence of lesional recurrence 18 months after the final treatment. CONCLUSION: The 585nm pulsed dye laser can effectively treat eccrine hidrocystomas. The mechanism of action whereby this vascular-specific laser produced improvement is unclear. ( info) |
| Extramammary fibroadenomas have been previously reported to mainly occur in the anogenital region, arising from mammary-like glands. The present report describes a 45-year-old woman who presented with a fibroadenoma of her eyelid that was associated with a cystadenoma. To our knowledge, this is the first case report of a fibroadenoma of the eyelid. The differential diagnosis and histogenesis of this lesion are discussed, and the literature pertaining to cutaneous fibroadenomas arising outside the breast is reviewed. ( info) |
| We describe the endorectal sonographic and magnetic resonance (MR) imaging findings of a hidrocystoma of the rectal wall, a tumor that arises in sweat glands and may occur in a perianal location. To our knowledge, occurrence in the rectum has not been reported previously. The unusual appearance of a solid lesion with a central fluid-filled cavity may suggest the diagnosis of a hidrocystoma. ( info) |
7/23. Multiple eccrine hidrocystomas: a new therapeutic option with botulinum toxin. BACKGROUND: Multiple eccrine hidrocystomas are benign cystic lesions that are associated with a chronic course and seasonal variability. Even though in the literature it is presented as a very infrequent pathology, we think this is more a lack of knowledge of the existence of said pathology and the fact that patients confuse it with comedo. OBJECTIVE: To treat multiple eccrine hidrocystomas of the face. RESULTS: We present a case of multiple eccrine hidrocystomas of the face in a cook man. hidrocystoma is a benign cystic tumor of the sweat glands eccrine or apocrine. Multiple eccrine hidrocystomas are benign cystic lesions that are associated with a chronic course and seasonal variability. They appear like multiple shining small papule. Although a solitary eccrine hidrocystoma can be treated easily with surgical excision, the elimination of multiple lesions is problematic because of their number and location. CONCLUSION: The benefits of BTX-A treatment for multiple eccrine hidrocystomas include ease of application, no risk of scarring, and a good postoperative course. Because of the blockage produced by BTX-A on cholinergic terminals of the parasympathetic system that governs sweat glands secretion, it is suggested that periodic doses of BTX-A are injected in the superficial epidermis in order to treat multiple eccrine hidrocystomas. ( info) |
8/23. High-frequency ultrasound imaging of periocular hidrocystomas. BACKGROUND: High-frequency ultrasound has improved our ability to manage and diagnose anterior segment tumors. Hidrocystomas are unusual cystic tumors that can affect the conjunctiva and eyelid. When they appear pigmented and rapid in onset, it is important to differentiate them from malignant tumors, such as melanoma. case reports: Three patients were referred to The new york Eye Cancer Center for evaluation of pigmented lesions on their eyes. The tumors affected the conjunctiva or eyelid and were of recent onset ranging from 1 week to 6 months. The hidrocystomas displayed hypoechoic high-frequency ultrasound patterns, which corresponded to the cystic nature revealed through histopathological analysis. Differential diagnoses are discussed and include benign and malignant tumors. CONCLUSION: Cystic tumors are a common finding of the eye; however, pigmented hidrocystoma is an uncommon diagnosis. Although histopathological study is often required for definitive diagnosis of these lesions, much information can be gained through pre-surgical evaluation, particularly high-frequency ultrasound. Intra-lesional cyst formation was characteristic in these three tumors. Further study of the high-frequency ultrasound characteristics of pigmented eyelid and conjunctival tumors will help determine if these ultrasound characteristics are diagnostic. ( info) |
9/23. Cystic basal cell carcinoma or hidrocytoma? The use of an excisional biopsy in a histopathologically challenging case. Basal cell carcinoma (BCC) has many histologic variants. These variants may show differentiation toward benign and malignant tumors of cutaneous appendages, especially hair follicles. Herein we describe a lesion that was clinically thought to be a BCC, but a superficial biopsy showed histologic features suggestive of an apocrine hidrocystoma. Because of some cytologic atypia, complete excision was recommended. The excision specimen revealed a cystic BCC. The importance of examining the entire neoplasm before reaching a final pathologic diagnosis is emphasized. ( info) |
10/23. Fine-needle aspiration of apocrine hidrocystoma--a potential mimic of papillary neoplasms metastasizing to the skin. We report the cytologic features of a histologically confirmed apocrine hidrocystoma as seen in fine-needle aspirates. The main cytologic features were the presence of sparse pseudopapillae with mild to moderate atypia in a background of an amorphous navy blue material reminiscent of that seen in aspirates of colloid nodules of the thyroid gland. The pseudopapillae were mistaken for malignant metastatic deposits. It is suggested that the presence of pseudopapillae in aspirates obtained from cutaneous nodules might be a clue for a tentative diagnosis of benign tumors of epidermal adnexae, with the proviso that a primary malignant tumor be ruled out first. ( info) |