Malignant Nodular Hidradenoma: Isolated Case Report and Review of Literature

Abstract

Summary:Malignant Nodular Hidradenoma is an infrequent highly malignant, primary skin tumor derived from eccrine sweat glands. It has an aggressive course, with high recurrence, high rate of metastases and has very poor prognosis. It has been described as an "orphan"neoplasm. The tumor is similar to its benign counterpart but had additional features such as surface ulceration, numerous mitotic figures and infiltrative growth pattern. Pre-operative diagnosis is difficult by the fine needle aspiration cytology. Malignant nodular hidradenoma of chest wall in 35 years old women, who presented to us with a recurrent rapidly growing swelling over chest wall that grew rapidly over two months after first excision. Tissue diagnosis of first excised specimen was eccrine poroma that was similar to its benign counterpart. criteria for malignancy include poor circumscription, presence of nuclear atypia, mitotic activity, presence of predominantly solid cell islands, infiltrative growth pattern, necrosis, and angio-lymphatic permeation 3-5 .We report a case of malignant nodular hidradenoma in a middle aged woman who presented with a recuurent swelling in right side of lower chest wall. Case report :A 35 years old female presented to us with swelling over right side of chest wall. The swelling was excised and sent for histopathology. The report was ecccrine proroma. But it recurred after two months. The swelling was rapidly increasing in size over the last one and half months. The mass became significantly prominent over the last 15 days prior to presentation resulting in discomfort.Physical examination revealed a large lobulated mass about 20 cmx15cm in size, without ulceration. It was hard, non-mobile, non-fluctuant and adherent to the old scar. The draining area showed no palpable lymphnode. General examination including lungs and liver were normal. Per-operatively, a hard fibrous tumor was observed to infiltrate the muscle but not to underlying ribs. Wide local excision with 1 cm marginal clearance of healthy surrounding tissue was performed along with primary closure. Biopsy was sent to pathological examination.

Malignant nodular hidradenoma-inguinal region clinically masquerading as squamous cell carcinoma: a case report

“…6 They typically stain with AE1/AE3, CK5, and CK6, with high Ki-67 expression helping to distinguish hidradenocarcinoma from atypical hidradenoma. 9 Occasional tumors may demonstrate the [11][12][13][14][15][16][17][18][19] translocation seen in clear cell hidradenomas. 7 CEA and EMA stain the luminal borders of ductal structures.…”

A 20-Year Retrospective Analysis of Skin Cancers: Comparison of the First and Second Decades

“…The pathological differential diagnosis of rare NMSC subtypes such as MCC, MNH, MEP and sebaceous carcinoma includes BCC and SCC. Different immunohistochemical dyes are used for differential diagnosis (79)(80)(81)(82). This increase may be due to an increase in the number of cases or it may be related to more accurate diagnosis with advanced detection methods and staining techniques.…”