Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 2395  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Article Submission Resources Sections Etcetera Contact
 
  NAVIGATE Here 
  Search
 
 :: Next article
 :: Previous article 
 :: Table of Contents
  
 RESOURCE Links
 ::  Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::Related articles
 ::  Article in PDF (12 KB)
 ::  Citation Manager
 ::  Access Statistics
 ::  Reader Comments
 ::  Email Alert *
 ::  Add to My List *
* Registration required (free) 

  IN THIS Article
 ::  Abstract
 ::  Case report
 ::  Discussion
 ::  References
 ::  Article Figures

 Article Access Statistics
    Viewed18117    
    Printed287    
    Emailed12    
    PDF Downloaded173    
    Comments [Add]    
    Cited by others 1    

Recommend this journal


 


 
CASE REPORT
Year : 1999  |  Volume : 45  |  Issue : 2  |  Page : 56-7

Malignant hidradenoma: a rare sweat gland tumour.


Department of Pathology, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, India., India

Correspondence Address:
P Vaideeswar
Department of Pathology, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, India.
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 0010734335

Rights and PermissionsRights and Permissions


 :: Abstract 

Malignant hidradenoma is a rare sweat gland carcinoma, which can have an aggressive course with recurrence and/or metastasis. A case is reported, in an elderly male. The tumour had a histologic similarity to its benign counterpart, but exhibited additional features of infiltrative growth pattern and invasion of adjacent tissue.


Keywords: Adenoma, Sweat Gland, pathology,Case Report, Human, Male, Middle Age, Sweat Gland Neoplasms, pathology,


How to cite this article:
Vaideeswar P, Madhiwale C V, Deshpande J R. Malignant hidradenoma: a rare sweat gland tumour. J Postgrad Med 1999;45:56

How to cite this URL:
Vaideeswar P, Madhiwale C V, Deshpande J R. Malignant hidradenoma: a rare sweat gland tumour. J Postgrad Med [serial online] 1999 [cited 2019 Nov 21];45:56. Available from: http://www.jpgmonline.com/text.asp?1999/45/2/56/349


Sweat gland carcinomas are rare neoplasms that possess an infiltrative and/or metastatic potential. They are generally classified into two groups. The first group comprises malignant tumours that closely mimic their benign counterparts while tumours in the second group do not have a benign counterpart[1]. We report a case of malignant hidradenoma, a tumour belonging to the first group.


  ::   Case report Top


A 55-year-old male had a recurrent swelling on the volar aspect of the right wrist. The swelling had had been excised in 1995. The swelling (three years after excision) measured 3.5 cm. in diameter and was firm, non-mobile, non-fluctuant and adherent to the old scar. Per-operatively, a hard fibrous tumour was observed to infiltrate the extensor tendon sheath and the pisiform bone.

Multiple irregular firm yellow-white fibrous bits aggregating 4 cm. were received. Few of the bits had a gelatinous surface while one of them was adherent to bone. None were covered by skin. Microscopically, the tumour was composed of solid nests of polygonal to small basaloid cells. Cribriform and adenoidal patterns were also seen. Clear cell change was also present [Figure - 1].

The tumour lobules were surrounded by a characteristic condensed stroma, which also extended into the tumour nests. There was no nuclear atypia or mitotic activity. However, the tumour exhibited an infiltrative growth pattern and had invaded the bone [Figure - 2]. A diagnosis of malignant hidradenoma was made.


  ::   Discussion Top


Sweat gland carcinomas are rare and among these, carcinomas included under the broad category of eccrine carcinomas are the commonest[2]. In a span of 77 years, Wick et al[3] found a mere 14 such cases. Malignant hidradenoma belongs to this group, and these are also infrequent. Among 35 cases of eccrine adenocarcinoma studied by Mehregan and associates[4], only two had the histologic features malignant hidradenoma. It mostly occurs in elderly males and is seen as a slowly growing swelling in the extremities for a prolonged duration. Grossly, they appear as nodular dermal masses with or without skin changes with a firm, fibrous appearance simulating a connective tissue tumour[2]. In the report, the tumour was present in an elderly male with a peroperative diagnosis of a fibrous tumour.

The histology of malignant hidradenoma resembles that of its benign counterpart. The criteria for malignancy include poor circumscription, presence of nuclear atypia and mitotic activity, predominantly solid cell islands, infiltrative growth pattern and angio-lymphatic permeation[2],[4],[5]. In the present case, there was a striking resemblance to benign nodular hidradenoma, because there was no nuclear changes or involvement of blood vessels. It was designated as malignant based on its recurrence, poor circumscription and an infiltrative pattern with invasion of the tendon sheath and bone. Such features are also sufficient to designate these tumours as malignant[2].

Malignant hidradenomas are most often malignant from their inception as seen in this case where the tumour was present for two years. Few others, however, develop from their benign counterpart. Half the tumours recur after initial local excision while other metastasise to lymph nodes and to distant sites, in due course of time. The tumour in this case recurred, following the second excision, the patient does not have tumour in a follow-up of one year.

 
 :: References Top

1.Murphy GF, Elder DE. Cutaneous appendage tumours. In: Atlas of Tumour Pathology, Fascicle 1 - Non-melanocytic tumours of the skin. Washington DC. Armed Forces Institute of Pathology. 1990, pp 61-154.  Back to cited text no. 1    
2.Cooper PH. Carcinomas of sweat glands. Pathol Annu 1987; 22:83-124.  Back to cited text no. 2    
3.Wick MR, Goellner JR, Wolfe JT, Su WPD. Adnexal carcinomas of the skin Eccrine carcinomas. Cancer 1985; 56:1147-1162.  Back to cited text no. 3    
4.Mehregan AH, Hashineto K, Rahbari H. Ecerine adenocarcinomas A clinicopathologic study of 35 cases. Arch Dermatol 1983; 119:104-114.  Back to cited text no. 4    
5.Headington JT, Neiderhuber JE, Beals TF. Malignant clear cell acrospiroma. Cancer 1978; 41:641-647.   Back to cited text no. 5    


    Figures

[Figure - 1], [Figure - 2]

This article has been cited by
1 Metastatic sweat gland adenocarcinoma: A clinico-pathological dilemma
Chintamani, Sharma RD, Badran R, et al
World Journal of Surgical Oncology. 2003; 1: 13
[VIEW]



 

Top
Print this article  Email this article
Previous article Next article
Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow