Areclinicianssuccessful in diagnosingcutaneousadnexaltumors? aretrospective, clinicopathologicalstudy

Abstract

Background/aim: Cutaneous adnexal tumors (CAT) are rare tumors originating from the adnexal epithelial parts of the skin. Due to its clinical and histopathological characteristics comparable with other diseases, clinicians and pathologists experience difficulties in its diagnosis.We aimed to reveal the clinical and histopathological characteristics of the retrospectively screened cases and to compare the prediagnoses and histopathological diagnoses of clinicians. Materials and methods:The data of the last 5 years were scanned and patients with histopathological diagnosis of CAT were included in the study.Results: A total of 65 patients, including 39 female and 26 male patients aged between 8 and 88, were included in the study. The female to male ratio was 1.5, and the mean age of the patients was 46.15 ± 21.8 years. The benign tumor rate was 95.4%, whereas the malignant tumor rate was 4.6%. 38.5% of the tumors were presenting sebaceous, 35.4% of them were presenting follicular, and 18.5% of them were presenting eccrine differentiation. It was most commonly seen in the head-neck region with a rate of 66.1%. When clinical and histopathological prediagnoses were compared, prediagnoses and histopathological diagnoses were compatible in 45% of the cases. Most frequently, it was the basal cell carcinoma, epidermal cyst, and sebaceous hyperplasia identified in preliminary diagnoses. Conclusion:Cutaneous adnexal tumors are very important, as they can accompany different syndromes and may be malignant. Due to difficulties in its clinical diagnosis, histopathological examination must be performed from suspicious lesions for definitive diagnosis.

A 5-year retrospective review of skin adnexal tumours received at a tertiary dermatopathology service: implications for linked genetic diagnoses

“…The literature is summarized in Table S4 (see Supporting Information). 3,9, Our population had a significantly higher female representation (male to female ratio of 0Á77 : 1) than that found in the reported literature (male to female ratio of 0Á98 : 1) and had The age of our cohort of patients was older than that reported in the existing SAT literature. The method of ascertainment in our work aimed to include all SATs, and the selected case mix of tumours is likely to have contributed to the difference in age seen in our cohort.…”

“…In a smaller study (n = 65 cases), 36Á4% of SATs were clinically unsuspected 9 and in another study (n = 528 cases) the clinical diagnosis was unsuspected in 51% of cases. 3 We found frequent discrepancies between the clinical and histological diagnosis in cases that were histologically diagnosed to be benign SATs, with a correct clinical diagnosis being provided only 28% of the time. SATs were not considered in the clinical differential in 41% of cases, with a further 16% of cases providing no attempt at diagnosis.…”

“…1,5,10 In contrast, the prior literature (Table S4) typically included these cases in their analyses, which contributed to 4-47Á9% of their cases. 3,9,12,13,[16][17][18][19][20]22,23,[25][26][27][28][29]33 The largest of these studies had a cohort of 1014 patients, and a significant proportion of these patients had cases that were of sebaceous differentiation (53%, 536 of 1014), the majority of which were sebaceous naevi and sebaceous hyperplasia (413 and 73, respectively). 9 This exclusion is likely to influence the age of presentation, as sebaceous naevi are common and tend to be excised at a younger age.…”

“…Histological analysis is required to reach a diagnosis, as their clinical appearance is often nonspecific. 3 SATs are predominantly benign, but malignancy is well recognized, 4 and the presentation of multiple SATs may be a cutaneous manifestation of an underlying genetic syndrome. 1,2,5 Additionally, genetic mutations that cause these tumours have been recently delineated in genomic studies of benign tumours, 6,7 and account for their frequent presentation in patients with predisposing germline genetic changes.…”

Cutaneous adnexal tumors: the diagnostic role of dermatoscopic examination

“…The results showed that clinical prediagnoses and histopathological diagnoses were compatible in 45% of the 65 patients, while they were contradictory in 51%. The authors concluded that cutaneous adnexal tumors should be included in the differential diagnosis list, particularly in the presence of cutaneous papulonodular lesions without specific features and that a histopathological examination must be done in suspicious cases to reach a definitive diagnosis [1]. Here, we would like to shortly discuss the contribution of dermatoscopic examination to diagnostic accuracy in cutaneous adnexal tumors.…”