Hidradenoma papilliferum associated with pregnancy: a case report

We present the case of a 33‐year‐old female who developed a cystic nodule on the vulva during pregnancy. Immediately following Cesarean section, the lesion was biopsied and histologic examination revealed a dermal tumor composed of glandular structures arranged in a labyrinth pattern. The glandular structures displayed cytoplasmic vacuolization, large atypical nuclei, prominent nucleoli and scattered eosinophilic luminal secretions. Immunohistochemistry showed the tumor cells to be diffusely positive for CK7 and progesterone receptor with focal expression of mammaglobin and GCDFP‐15. The tumor cells were negative for estrogen receptor and CK20. These histologic and immunophenotypic findings were consistent with hidradenoma papilliferum. Our unusual (and to our knowledge first reported) case demonstrates hidradenoma papilliferum in association with pregnancy and raises the possibility of cytologic atypia and lactational change being secondary to hormonal changes in pregnancy.     

疣状癌1例

患者女性，２５岁，４年前，左足因外伤在足背处长一肿块，采用抗真菌，抗痨及冷冻治疗均无效。皮损渐增大，呈菜花状生长，组织病理检查示疣状癌，作者分析了疣状癌的临床表现及病理改变，并讨论了疣状癌与鳞状细胞癌的不同之处。     

乳头状汗管囊腺瘤1例

报告1例乳头状汗管囊腺瘤。患者女,16岁。左耳前丘疹逐渐增多16年。临床表现为左耳前带状排列淡红色丘疹,部分中央有脐凹。组织病理诊断为乳头状汗管囊腺瘤。     

Verrucous carcinoma of the axilla: case report and review

BACKGROUND: Verrucous carcinoma, a variant of squamous cell carcinoma, is distinct from squamous cell carcinoma in morphology and behavior. It preferentially occurs on the oropharyngeal mucosa, the urogenital mucosa, and the soles. In contrast to its malignant clinical picture, the tumor grows locally invasive but is histologically benign and metastasizes rarely. METHODS: We report the uncommon occurrence of a large verrucous carcinoma on apparently uninvolved skin in the right axilla in a 47-year-old male. RESULTS: Histologic examination reveals a cauliflower-like tumor consisting of deep invaginated epidermal proliferation with rabbit burrow-like, keratin-filled sinus formations; the basement membrane, however, remains intact. Immunohistology showed positivity for pancytokeratin (KL-1) and cytokeratin (CK) 18 and negativity for CK7, and assessment of the proliferative activity of the tumor cells revealed low percentage of Ki-67 expression. Furthermore, there were only scattered cells expressing p53 or bcl-2. Polymerase chain reaction excluded the presence of human papillomavirus. After complete excision, no signs of recurrence occurred over a follow-up period of three years. CONCLUSION: Verrucous carcinoma should be distinguished from typical squamous cell carcinoma. The clinicopathological features, differential diagnosis, and therapy are discussed here together with the molecular biologic aspects of the tumor.     

头顶乳头状汗管囊腺瘤一例

患者,男,24岁。因头顶部出现十余个黄豆大皮疹多年,加重半年来就诊。半年前无明显诱因下左侧头顶出现红色丘疹,散在分布,无瘙痒和疼痛,发展缓慢。近半年突然增多。发病后患者曾在当地医院使用口服抗组胺药和外用糖皮质激素药膏,效果不佳。近两个月皮疹红明显,进行性增大,无破溃。     

Hidradenoma papilliferum with a ductal carcinoma in situ component: case report and review of the literature

Hidradenoma papilliferum (HP) is a benign cutaneous adnexal neoplasm occurring mainly in the anogenital region of adult women and has features analogous to intraductal papilloma of the breast. Malignant change in HP is extremely rare. Only a single case of ductal carcinoma in situ arising in HP has been previously reported. We present a new case of HP which, in addition to the typical appearance of HP, contained a focus of ductal carcinoma in situ that appeared as enlarged pleomorphic epithelial cells having a "blastic" appearance, exhibiting atypical mitotic figures and surrounded by myoepithelial cells. Molecular biological study identified human papillomavirus (HPV)-16, which, it may be argued, may have played a role in the development of the carcinoma.     

Syringocystadenoma papilliferum associated with verrucous carcinoma of the skin in the same lesion: Report of four cases

The association of syringocystadenoma papilliferum (SCAP) with verrucous carcinoma (VC) of the skin in the same lesion is a rare, but well-documented event. Although human papillomaviruses (HPV) have been proposed to have an etiologic role in the development of the verrucous proliferations associated with SCAP, most of the immunohistochemical and molecular studies have failed to show the presence of their genomic material in these lesions. We report a series of four cases of SCAP associated with VC in anogenital lesions. In two of the cases, we demonstrated the presence of the BRAF ^V600E mutation by polymerase chain reaction and immunohistochemistry, both in the glandular and in the squamous component. No HPV-related histopathologic changes were found, nor could the presence of viral DNA be showed.     

原发皮肤黏液癌

报告1例原发皮肤黏液癌.患者男,57岁.右胸部乳晕处出现红色斑块2年.体格检查示右乳晕部位有形态不规则的浸润性红色斑块,斑块最大直径约2 cm,未见明显糜烂和渗出.组织病理学检查示真皮内大小不一、腺样分化的肿瘤细胞团块,肿瘤细胞有异形性.连续切片示肿瘤组织在局部与外泌汗腺导管相连,提示为外泌汗腺来源肿瘤.肿瘤细胞团块周围形成大量空腔,阿新蓝染色显示大量黏蛋白沉积.临床和组织病理学资料提示该例为乳房部位的皮肤黏液癌,其来源为外泌汗腺,需要和来源于乳腺的黏液癌鉴别.     

Extraocular sebaceous carcinoma of the skin with visceral metastases: case report

Extraocular sebaceous gland carcinomas of the skin are uncommon neoplasms that may recur locally, but in contrast to their ocular counterparts infrequently metastasize. A case is reported in which a 62-year-old woman had a 1 cm scalp tumor incompletely excised. Microscopic examination revealed a sebaceous carcinoma. No further surgical treatment was performed and 31 months after diagnosis the patient presented with regional and distant metastases resulting in death. It is emphasized that extraocular sebaceous carcinoma may behave in a biologically aggressive manner, just as their counterparts arising in the ocular adnexae, and the necessity to ensure complete tumor excision is stressed.     

Ectopic hidradenoma papilliferum: a case report and review of the literature.

Hidradenoma papilliferum is a benign, cystic, papillary tumor that occurs almost exclusively in women on the skin of the anogenital region. Nonanogenital (ectopic) hidradenoma papilliferum are rare. We describe a 72-year-old white man with an enlarging nodule in the region of the right triceps muscle; microscopic examination showed a hidradenoma papilliferum. The median age of patients with ectopic hidradenoma papilliferum is between 1 to 2 decades older than the average age range of lesion onset in patients with anogenital hidradenoma papilliferum. In contrast to anogenital hidradenoma papilliferum, nearly one half of the patients with ectopic hidradenoma papilliferum are men. Ectopic hidradenoma papilliferum occurs most frequently (60%) in the head and neck region. Eighty-five percent of cases are 1.5 cm in the greatest diameter or smaller. The race, clinical features, pathologic features, treatment, and prognosis for hidradenoma papilliferum occurring in anogenital and ectopic locations are similar.     

Hidradenoma papilliferum with mixed histopathologic features of syringocystadenoma papilliferum and anogenital mammary-like glands: report of a case and review of the literature

Hidradenoma papilliferum of the anogenital region was previously believed to originate from apocrine glands but has recently been accepted as originating from anogenital mammary-like glands. We describe a case of hidradenoma papilliferum with mixed features of syringocystadenoma papilliferum and mammary-like glands from the left labia majora of a 25-year-old woman. Histopathologically, the lesion showed an epithelial lining with apocrine secretion, and like syringocystadenoma papilliferum, the lesion extended from the epithelium as invaginations into the dermis. Adjacent to this lesion were ductal and glandular structures resembling normal mammary tissue. This review of the literature highlights the heterogeneity and complexity of lesions arising from anogenital mammary-like glands, and this case serves as further documentation of the association between anogenital mammary-like glands and hidradenoma papilliferum.     

头皮小汗腺痣合并乳头状汗管囊腺瘤1例

报告1例罕见头皮小汗腺痣合并乳头状汗管囊腺瘤。患者男,78岁,出生时即发现头皮黄豆大小肿物。皮肤科检查：头皮顶部可见一肤色及玫瑰红色斑块。皮损组织病理检查示：部分表皮呈疣状增生,真皮深层可见大量结构正常的小汗腺腺体及导管;另一部分表皮向真皮凹陷形成囊状腔,囊状腔下部可见乳头状突起,乳头状突起由两排细胞组成,乳头状突起基质内可见较多浆细胞。诊断：头皮小汗腺痣合并乳头状汗管囊腺瘤。予手术切除皮损及皮瓣修复术。术后18个月电话随访无复发。     

Sialadenoma papilliferum of the palate: case report and literature review

Sialadenoma papilliferum (SP) is a rare tumor of salivary gland ducts which bears a strong histologic resemblance to the more common syringocystadenoma papilliferum (SCAP). We report a case occurring on the palate of a 50-year-old man, and review the clinical and histologic features of this tumor. Because of the histologic similarities between these two tumors and squamous papillomas, polymerase chain reaction (PCR) for human papilloma virus (HPV) DNA was performed on this tumor and on two cases of SCAP, with negative results. To our knowledge, this is the first case report of SP in the dermatopathology literature.     

Syringocystadenocarcinoma papilliferum: case report and immunohistochemical comparison with its benign counterpart

Syringocystadenocarcinoma papilliferum (SCACP) is the malignant counterpart of syringocystadenoma papilliferum (SCAP), although only a few cases have been reported in the literature and its clinical and histologic characteristics are not well known. We report a case of SCACP that started as an enlarging nodule over 10 years in the perianal area of a 61-year-old man. Macroscopically, the lesion was a black exophytic tumor, 6 cm in diameter, with a granular surface. Histologically, it was an in situ adenocarcinoma, showing cytologic atypia and pagetoid spread in the surrounding epithelia, although the clinicopathologic features were distinct from extramammary Paget's disease. The tumor lacked the typical double-layered pattern of SCAP but had some similar histopathologic features to SCAP. Decapitation secretion was apparent and there was positive immunoreactivity to epithelial membrane antigen and human milk fat globules subclass 2. SCACP is a rare cutaneous tumor but nevertheless represents a specific dermatopathologic entity.     

Syringocystadenoma papilliferum: report of the first case on the lower leg

Syringocystadenoma Papilliferum (SCAP) is a benign adnexal tumor which most frequently arises from an organoid nevus on the head and neck. Although they are rarely found on the trunk and limbs, we treated a case of this disorder on the lower leg. A 26-year-old man had an asymptomatic tumor on his lower leg. Histopathological examination showed it to be a typical SCAP on organoid nevus. This is the first report of SCAP on the lower leg.     

Granulomatous slack skin: report of a case associated with Hodgkin's disease and a review of the literature

We report a case of granulomatous slack skin (GSS) associated with Hodgkin's disease, and review the literature on this entity. GSS, a variant of cutaneous T-cell lymphoma, clinically presents with erythematous patches in the flexures, which gradually transform into bulky, pendulous areas of skin. Histology shows an elastolytic granulomatous infiltrate, with atypical lymphoid cells, and occasional epidermotropism. As far as we are aware, 10 cases of GSS, including our patient, have been reported in detail. The male: female ratio of these cases is 9:1, and the age range 15–51 years. Five cases were associated with Hodgkin's disease, one with small lymphocytic lymphoma, and one developed cutaneous T-cell lymphoma. The axillae, abdomen and groins were the most frequently affected areas. No definitive management for GSS has been established. Surgery has been performed in localized forms, and systemic treatments have included corticosteroids, dapsone, chlorambucil, nitrogen mustard, and radiotherapy. Our patient was treated with chemotherapy for his Hodgkin's disease, and this resulted in complete remission of the lymphoma. Subsequent maintenance therapy with interferon-alpha produced good control of the cutaneous lesions.     

白化病伴发颈后鳞癌1例

报告1例白化病伴发颈后鳞癌。患者男,45岁,颈后硬结10年,斑块,溃疡7月。血常规、X光胸片及腹部B超无异常。组织病理检查示高分化鳞癌。治疗行颈后鳞癌全切除术及局部淋巴结清除术。     

Syringocystadenocarcinoma papilliferum with transition to areas of squamous differentiation: a case report and review of the literature

Syringocystadenocarcinoma papilliferum (SCACP) is an exceedingly rare cutaneous adnexal neoplasm, which is typically located in the head and neck, and perianal area. Very few cases have been reported in the literature. Here, we report a case of SCACP with evident transition to squamous differentiation. A 75-year-old white woman presented with 1-year history of a solitary tender nodule in the left upper arm. Physical examination revealed a single, 1.5 × 1.1-cm, erythematous ulcerated nodule within a background of red patch. Biopsy showed an adnexal carcinoma connected to the epidermis and composed of cystic papillary projections admixed with solid basaloid areas with marked cytologic atypia. The basaloid tumor cells appeared to blend with the squamous component that demonstrated ductal formation, which was highlighted by carcinoembryonic antigen. Tumor cells were reactive for both cytokeratins 5/6 and 7. This case represents SCACP arising from syringocystadenoma papilliferum in the upper arm, with distinct transition to areas of squamous differentiation.