Cases reported "Adenoma, Sweat Gland"

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1/272. A reactive acrosyringeal proliferation in a patient with ectodermal dysplasia: eccrine syringofibroadenoma-like lesion.

    A 33-year-old man with ectodermal dysplasia (ED) has suffered from keratotic, exudative, erythematous plaques on the genital area, thighs, and soles since age 17. Verrucous soft nodules in a cobblestone arrangement developed on the erythematous plaque on his left thigh when he was 31 years old. Histologic examination of the verrucous nodules demonstrated that they were composed of anastomosing thin cords of uniform, cuboidal, epithelial cells and a fibrovascular stroma. The changes are indicative of eccrine syringofibroadenoma of Mascaro (ESFA), which has been reported as a neoplasm, a hamartoma, or a nevus. With etretinate treatment, the verrucous nodules completely disappeared within two months. Similar, but much flatter, verrucous lesions recurred and disappeared twice during the subsequent two years period. These verrucous lesions were likely induced by irritation from urine, stool, and/or mechanical friction. This case of ESFA in a patient with ED clearly showed a reactive process which was successfully managed with oral etretinate. ( info)

2/272. Malignant eccrine spiradenoma: a previously unreported presentation and review of the literature.

    Malignant eccrine spiradenomas (MESs) are rare tumors arising from previously benign eccrine spiradenomas. A review of the literature reveals only 25 published reports of malignancy arising from eccrine spiradenoma and no prior reports of an MES of the scalp. The tumors have a metastasis rate of >50 per cent in reported cases with high resultant mortality rates. We present the first case report of a single MES of the scalp. Multiple resections were required for local control. Both magnetic resonance imaging and lymphoscintigraphy were used to assess regional spread. A review of the literature follows to include histopathology, diagnosis, and both surgical and adjuvant therapeutic options. ( info)

3/272. MRI appearance of clear cell hidradenoma.

    We present the first reported MR imaging findings of a histologically proven clear cell hidradenoma. A fluid level was noted on all pulse sequences in this lesion, which demonstrated a prominent hemorrhagic component on sectioning. The presence of an enhancing nodule was also noted, differentiating this lesion from a post-traumatic hematoma. Fluid levels in a well-defined subcutaneous soft tissue mass should suggest the possibility of a hidradenoma. ( info)

4/272. Extensive naevoid eccrine spiradenoma.

    We describe a 19-year-old girl with a painful naevoid eccrine spiradenoma affecting the right side of the body. This represents an extremely rare variant of this benign eccrine sweat gland tumour, and is the most extensive lesion described in the U.K. to date. ( info)

5/272. Poroid hidradenoma. Report of a case with cytologic findings on fine needle aspiration.

    BACKGROUND: Fine needle aspiration cytology (FNAC) can be used for establishing a diagnosis of cutaneous lesions, especially in cases with cyst formation. Poroid hidradenoma is eccrine neoplasm with both solid and cystic components. CASE: A 77-year-old female presented with a slightly elevated nodule in the skin on her left elbow. The tumor was well demarcated, 2.7 x 2.4 cm and soft, and overlying skin was slightly reddish. FNAC revealed two types of cell: one had abundant cytoplasm in which small to large, occasionally multinucleated nuclei with small but distinct nucleoli were evident. chromatin was finely granular, and nuclear membrane was thin and almost smooth. Another type of cell had scanty cytoplasm and a round to oval nucleus with small but prominent nucleoli. Histologic diagnosis was poroid hidradenoma. CONCLUSION: FNAC can be useful for diagnosing intradermal cystic lesions before surgical resection. ( info)

6/272. Ectopic hidradenoma papilliferum: a case report and review of the literature.

    Hidradenoma papilliferum is a benign, cystic, papillary tumor that occurs almost exclusively in women on the skin of the anogenital region. Nonanogenital (ectopic) hidradenoma papilliferum are rare. We describe a 72-year-old white man with an enlarging nodule in the region of the right triceps muscle; microscopic examination showed a hidradenoma papilliferum. The median age of patients with ectopic hidradenoma papilliferum is between 1 to 2 decades older than the average age range of lesion onset in patients with anogenital hidradenoma papilliferum. In contrast to anogenital hidradenoma papilliferum, nearly one half of the patients with ectopic hidradenoma papilliferum are men. Ectopic hidradenoma papilliferum occurs most frequently (60%) in the head and neck region. Eighty-five percent of cases are 1.5 cm in the greatest diameter or smaller. The race, clinical features, pathologic features, treatment, and prognosis for hidradenoma papilliferum occurring in anogenital and ectopic locations are similar. ( info)

7/272. Spiradenocylindromas of the skin: tumors with morphological features of spiradenoma and cylindroma in the same lesion: report of 12 cases.

    Twelve cases of spiradenocylindromas, which revealed features of both spiradenoma and cylindroma in the same tumor mass, are presented. Nine female patients had multiple neoplasms occurring mostly on the scalp, and two female and one male patient had a solitary cutaneous lesion. Three of the female patients with multiple cutaneous tumors had a familial history of similar cutaneous neoplasms. In one of the patient's family, the multiple cutaneous tumors were known to occur in multiple family members in four consecutive generations. One patient with multiple cutaneous lesions was known to have associated multiple kidney cysts as confirmed by computed tomography. Histologically, spiradenocylindromas are composed of intermixed areas that are either of typical spiradenoma in appearance or of typical cylindroma appearance. Apocrine and trichoepitheliomatous differentiation seen in two cases in the present series points to spiradenomas, as well as cylindromas, having complex hair follicle (folliculo-sebaceous apocrine) rather than eccrine differentiation. The presence of lymphoid tissue was a histological feature in the present series, which was prominent in all the spiradenomatous parts of the tumors and which was scanty or practically absent in all the cylindromatous parts. The selective presence of lymphocytes in spiradenoma and an absence in cylindroma suggest that spiradenomas have the unique property of attracting lymphocytes. The malignant tumors arising in three patients in the present series had the morphology of a poorly differentiated epithelioid neoplasm. Three patients died of the disease and the other patients were either free of disease or alive with disease 1-30 years on follow up. ( info)

8/272. Eccrine syringofibroadenoma treated with a dual pulse width flashlamp pumped pulsed dye laser.

    BACKGROUND: Eccrine syringofibroadenoma is a rare benign eccrine ductal proliferation with a predilection for the extremities, most often found in middle-aged and elderly patients. Reported treatments have included excision and conventional destructive modalities; however, recurrences may be common. OBJECTIVE: We describe a patient with a chronic ulcerated verrucoid eccrine syringofibroadenoma that persisted despite cryotherapy or curettage and electrodessication. RESULTS: Treatment with a dual pulse width flashlamp pumped pulsed dye laser (FPDL) produced an excellent clinical response. CONCLUSION: Treatment of eccrine syringofibroadenoma with a FPDL may provide both a vascular specific injury, analogous to the treatment of verruca vulgaris, and nonspecific thermal destruction at high fluences. ( info)

9/272. Reactive eccrine syringofibroadenoma: an association with chronic foot ulcer in a patient with diabetes mellitus.

    Eccrine syringofibroadenoma is a rare skin tumor with a variety of reported clinical manifestations. We report a case of reactive eccrine syringofibroadenoma associated with a chronic skin ulcer of the foot in a patient with diabetes mellitus. ( info)

10/272. Spiradenoma arising in a nevus sebaceus of Jadassohn: case report and literature review.

    nevus sebaceus (NS) of Jadassohn is usually a verrucous plaque on the scalp or face that arises secondary to disordered development of epithelial, pilar, sebaceous, and apocrine structures. The emergence of neoplasia is a late stage in the natural history of NS. Although most neoplastic proliferations are benign, several malignant tumors have arisen in this lesion. We describe the first case of a benign spiradenoma arising in an NS on the scalp in a 72-year-old Caucasian woman. Reexcision was recommended to prevent the development of a second neoplastic process and to avoid the rare occurrence of a malignant transformation of the existing neoplasia. The patient declined reexcision and remains under observation. The spectrum of tumors arising in NS are described and are categorized according to behavior. Syringocystadenoma papilliferum is the most commonly observed benign growth, whereas basal cell carcinoma is the most frequently seen malignant process. The signs of tumor development (benign or malignant) within an NS are reviewed, and treatment recommendations are provided. The clinical course of rare and unique aggressive neoplasms originating in NS is summarized. ( info)
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