Background. Nodular hidradenocarcinoma (NHAC), an eccrine carcinoma, has been reported in the dermatology and pathology literature, but few references have been made in the otolaryngology literature even though the head and neck is a common site of occurrence.Methods. A case report of a 37-year-old Hispanic man with a right-sided neck mass diagnosed preoperatively as a parotid mass by imaging and fine-needle aspiration is presented. After presentation at our multidisciplinary tumor board, excision of the mass was undertaken.Results. Final pathology reveled a NHAC, which is presented in our report.Conclusion. NHAC is an aggressive malignant tumor that is often misdiagnosed preoperatively and that must be treated with aggressive multimodality therapy for increased survival. Head Neck 29: 193-197, 2007 Keywords: nodular hidradenocarcinoma; eccrine tumor; malignant skin tumor; skin cancer Nodular hidradenocarcinoma (NHAC) is a malignant cell eccrine tumor, often with clear cell morphology, which has been reported less than 60 times in the literature. It has been rarely reported in the otolaryngology literature, though the head and neck is a common site of occurrence. The tumor has been identified in the literature under many names including clear-cell hidradenocarcinoma, malignant clear-cell hidradenoma, solidcystic adenocarcinoma, malignant acrospiroma, malignant clear-cell myoepithelioma, and clearcell eccrine carcinoma. 1 NHAC tumors usually develop as malignant tumors, though there have been reports of malignant degeneration of the benign counterpart, hidradenomas. 2 We present the case of a patient with what was believed to be a parotid neoplasm by preoperative clinical examination that turned out to be a hidradenocarcinoma.
CASE REPORTA 37-year-old otherwise healthy Hispanic man presented to our tertiary care hospital complaining of a painless right neck mass that the patient said had been present for approximately 3 months. On physical examination the patient had a 4 cm 3 2 cm right parotid mass that appeared to be connected to the skin though there were no skin changes. Facial nerve function was House Brackmann I/VI bilaterally. The patient was sent for fine-needle aspiration of the neck mass, which showed cellular clusters and sheets of monomorphous epithelial cells with low nuclear:cytoplasm