Apocrine cystadenoma and apocrine hidrocystoma: examination of 21 cases with emphasis on nomenclature according to proliferative features

Sugiyama, Akiko; Sugiura, Masatoshi; Piris, Adriano; Tomita, Yasushi; Mihm, Martín C.

doi:10.1111/j.1600-0560.2007.00757.x

Cited by 58 publications

(37 citation statements)

References 10 publications

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“…15 Several studies have shown that the MIB-1 index is a helpful prognostic marker in adnexal neoplasms. 2,16,17 Histone H3 protein is maximally phosphorylated during the mitotic phase of the cell cycle, making the PHH3 a specific marker for mitosis. 18 The PHH3 marker has been studied in a few other neoplasms, including meningiomas, vaginal intraepithelial malignancy, and ovarian epithelial tumors, and has been found to be prognostically useful.…”

Section: Discussionmentioning

confidence: 99%

Atypical and malignant hidradenomas: a histological and immunohistochemical study

et al. 2009

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The histological features of atypical hidradenoma are worrisome for increased risk of recurrence and possible malignant potential; however, earlier studies with immunohistochemistry or patient follow-up have not been reported. In addition, immunohistochemical analysis of hidradenocarcinoma exists in the literature mainly as case reports and as a single series of six cases. We compare the histological features and Ki-67, phosphorylated histone H3, epidermal growth factor receptor, and Her2/neu expression profiles of 15 atypical and 15 malignant hidradenomas with those of benign hidradenoma and metastasizing adnexal carcinomas. Infiltrative growth pattern, deep extension, necrosis, nuclear pleomorphism, and Z4 mitoses per 10 high-power fields are specific features of hidradenocarcinomas. Significant difference in mean Ki-67% was observed between benign and malignant hidradenomas (Po0.001), benign and metastasizing adnexal carcinomas (0.002), atypical and malignant hidradenomas (Po0.001), and between atypical hidradenomas and metastasizing adnexal carcinomas (0.002). Significant difference in mean phosphorylated histone H3% was observed between benign and malignant hidradenomas (Po0.001), benign and metastasizing adnexal carcinomas (0.003), atypical and malignant hidradenomas (Po0.001), and between atypical hidradenomas and metastasizing adnexal carcinomas (Po0.001). Mean epidermal growth factor receptor total score was significantly different in benign and atypical hidradenoma when compared with that in metastasizing adnexal carcinoma (P ¼ 0.014 and 0.019, respectively). Equivocal or 2 þ Her2/neu positivity was observed in one hidradenocarcinoma and in two metastasizing adnexal carcinomas. Receiver operating characteristic curve analysis for Ki-67 and phosphorylated histone H3% positivity reveals statistically significant criterion values of 411.425 and 40.7, respectively, for distinguishing malignant hidradenomas from atypical hidradenomas. Despite the presence of some worrisome histological features, the significantly different immunoprofile from the malignant counterpart suggests that atypical hidradenomas are likely to recur but are unlikely to metastasize. A tumor with Ki-67411% and/or phosphorylated histone H340.7% would likely be a malignant rather than an atypical hidradenoma. The infrequent Her2/neu overexpression in hidradenocarcinoma suggests its limited therapeutic role.

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Section: Discussionmentioning

confidence: 99%

Atypical and malignant hidradenomas: a histological and immunohistochemical study

et al. 2009

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“…Occasionally, the cyst cavity is partially replaced by a papillary or adenomatous proliferation, and then the term AC is used to refer these lesions. 12 Our cases show that DPC can mimic AH and AC both clinically and histopathologically, particularly if only superficial or partial biopsies are available. A diagnosis of DPC should always be suspected when an "AH" or an "AC" is observed on the digits or toes.…”

Section: Discussionmentioning

confidence: 70%

“Apocrine Hidrocystoma and Cystadenoma”–like Tumor of the Digits or Toes

Molina-Ruiz

Llamas‐Velasco

Rütten

et al. 2016

American Journal of Surgical Pathology

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Digital papillary carcinoma (DPC) is a rare, underreported, and often misdiagnosed malignant tumor of the sweat glands. It is often located on the digits and toes and most commonly occurs in male individuals in their fifties to seventies. Because of lack of pain, slow growth, and an inconspicuous appearance, clinical diagnosis is often missed or delayed. In contrast, apocrine hidrocystoma (AH) is a cystic adenoma that arises from the apocrine secretory coil, and it is extremely rare for AHs to develop on the digits. We report 7 cases of DPC, including clinical course, histopathologic and immunohistochemical findings, and therapeutic approach in which the initial histopathologic diagnosis in all cases was AH or cystadenoma. However, complete excision of the neoplasms led to a final diagnosis of DPC. After an adequate treatment, no recurrence or metastasis was found in any of the cases described. All the cases studied showed similar histopathologic and immunohistochemical findings. The initial incisional biopsy showed large unilocular or multilocular cystic spaces situated within the dermis, lined by a double layer of epithelial cells with tiny papillary structures. No cellular atypia, necrosis, or pleomorphism was observed. However, complete excision revealed neoplastic lesions involving the dermis and/or subcutis, with an infiltrative pattern and papillary projections into luminal spaces. Immunoperoxidase studies showed positivity for CK7, S-100 protein, CEA, p63, smooth muscle actin, and calponin. DPC is a rare but life-threatening malignancy, therefore it is important to be able to identify such a lesion both clinically and histopathologically, treat it, and monitor the patient for the tumor's potential recurrence and metastasis. Pathologists and dermatopathologists should be aware that a histopathologic diagnosis of AH or cystadenoma on the fingers and toes should be established with caution, because probably those lesions represent the superficial and cystic component of an underlying DPC, and a wider excision should be performed.

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“…Apocrine papillary cystadenoma consists of a large unilocular or multilocular cystic space with focal papillary proliferation (3). Its cystic characteristic, focal papillary proliferation, nuclear atypia and mitotic activity differ from hidradenoma papilliferum (3,4). Clinically, unlike tbe skincoloured nodule of hidradenoma papilliferum, apocrine papillary cystadenoma presents as a translucent, blue or purple cystic nodule (3).…”

Section: Discussionmentioning

confidence: 97%