Recurrent eccrine hidradenoma of the breast in a male patient: problems in differential diagnosis

Abstract

Introduction: Hidradenoma is an uncommon usually benign tumor of the skin that grows slowly. Case report: We describe a case of a 39 patient with a breast mass. Physical examination revealed a solitary, well-circumscribed tumor, measuring 1 cm by 0.7 cm. No other skin abnormalities were found. A total surgical excision was performed and histologic examination concluded to an eccrine hidradenoma with clear cells. Conclusion:Here we discuss problems in the differentiate this tumor, mainly in this not common location, from a breast primary (ductal carcinoma or adenomyoepitelioma), from a metastatic clear cell carcinoma and from other types of skin tumors. Moreover, this patient presented with a recurrence of the tumor in the same location, suggesting a locally aggressive form of this neoplasia; few reports in the literature are described as at low malignant potential, but definite criteria for this diagnosis are not well defined.

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.…”

Malignant Clear Cell Hidradenoma of the Breast

“…Clear cell hidradenoma of the breast is a rare tumor with only 18 reported cases in the literature, with the malignant variant being extremely rare [1,3]. The benign variant of the tumor commonly occurs in middle-aged women but the malignant form has no age or gender tendency [3].…”

“…The HER-2 staining has also proved to be useful, as less than 0.5% of cutaneous eccrine and apocrine neoplasms will stain positive, compared to 20%-35% of breast adenocarcinomas. Myoepithelial antibodies such as calponin, CD10, and S100 would be negative and assist in differentiating from an adenomyoepithelioma [1]. …”

“…These neoplasms have been considered to originate from the eccrine gland, but can also have apocrine differentiation. Only rarely have these tumors been identified in the breast, with only 18 reported cases in the literature [1]. Due to the rarity of the tumor, it is often a diagnostic challenge and only confirmed after complete excision.…”

Clear Cell Hidradenoma of Breast Mimicking Atypical Breast Lesion: A Diagnostic Pitfall in Breast Cytology

“… 2 , 4 This entity is seen most often in young adults and appears to be slightly more common in women than in men. 5 Common sites of origin of CCH are face, upper extremity, axilla, trunk, thigh, scalp and pubic region. 2 , 4 CCH of breast is very rare and only few cases have been reported in English literature.…”