Zur Lehre vom Epithelioma adenoides cysticum Brooke

Ohne ZusammenfassungMit 5 Textabbildungen.     

Transformation of epithelioma adenoides cysticum into multiple rodent ulcers: fact or fallacy

This historical study has examined the persistent controversy about the propensity of epithelioma adenoides cysticum (EAC) to transform into multiple rodent ulcers, by reviewing cases reported through the years that seemed to support the idea. After focusing on the biological behaviour and natural history of the tumours and comparing them with our present knowledge of the behaviour of EAC, we believe that these cases were incorrectly diagnosed. Rather than EAC, hey were probably examples of the naevoid basal cell carcinoma syndrome. The latter syndrome was actually established by the recognition that patients who have multiple rodent ulcers that appear early in life and behave aggressively usually have a constellation of associated developmental defects and that the tumours should be classified as genetically determined basal cell carcinomas and not as EAC.     

Multiple vascular eccrine spiradenomas: a case report and published work review of multiple eccrine spiradenomas

Eccrine spiradenoma (ES) usually occurs as a solitary small nodule. It presents rarely as multifocal or multiple localized tumors arranged in a linear, zosteriform or nevoid distribution. We present a rare case of a 55-year-old woman who had a 48-year history of multiple vascular eccrine spiradenomas (VES) localized on the left side of the submandibular region and neck. All five tumors were skin-colored or pinkish-purple, and ranged in size 1.5-2.5 cm. Histologically, each tumor was composed of two characteristic cell types and many dilated vascular spaces were noted in the stroma. Contrast-enhanced computed tomography showed irregularly shaped, enhanced areas at the center of the tumors. A published work search revealed 35 cases of multiple ES, but multiple VES was extremely rare. We summarized the features of previously reported multiple ES and discuss the clinical and histological classification of ES.     

Multiple linear eccrine spiradenomas with eyelid involvement

Eccrine spiradenoma is an uncommon tumour of the sweat gland and usually occurs as a solitary small painful nodule. Very rarely, it may present as multiple tumours arranged in a linear/zosteriform fashion. We present the case of a 23-year-old female who had multiple spiradenomas arranged linearly from the midline of forehead to the left corner of the mouth and a few lesions also on the margin of the left eyelid. The lesions were probably along the Blaschko's lines. Tumours were excised surgically in stages. Literature search revealed only 13 reported cases of linear/zosteriform/naevoid multiple spiradenomas and only four cases of solitary spiradenoma of the eyelid. The review of reported cases suggests that arrangement of tumours in a linear/zosteriform pattern is an important diagnostic clue for multiple (naevoid) spiradenomas.     

Basal cell tumor with eccrine differentiation (eccrine epithelioma)

A case of eccrine epithelioma is presented. A 62-year-old woman was seen for with a lesion on the left forearm present for 36 years, and complicated by multiple recurrences. Histopathologically, it was composed of numerous small nests of basaloid cells, cystic and syringoid epithelial structures within the reticular dermis and invading the contiguous fat mid muscle tissues. Tubular structures and cystic spaces contained PAS-positive, diastate-resistant, and alcian blue-positive material. Although the tumor was very aggressive locally, no metastasis had occurred throughout its long course.     

Multiple linear eccrine spiradenoma associated with multiple trichoepithelioma

A 37-year-old woman had multiple trichoepithelioma of the face which showed typical clinical and histological features, together with multiple papular lesions of 30 years' duration. The lesions were arranged in a linear fashion on her right breast and right upper arm. Microscopic examination of a biopsy specimen revealed typical eccrine spiradenomas. An ultrastructural study of the tumor on the breast revealed that it was composed of two main types of cells: one was a clear cell with low-density cytoplasm and the other was a dark cell with high-density cytoplasm. Some of the clear cells had secretory granule-like structures and/or tono-fibrils, while others had intracytoplasmic cavitations. Neither myoepithelial cells nor Langerhans cells were observed.     

Familial occurrence of multiple basalomas associated with hyperostotic spondylosis

We report on brother and sister suffering from hyperostotic spondylosis and multiple basal cell carcinomas. Localisation and multiplicity of the tumors are remarkable. On account of the family tree, we assume recessive inheritance.     

An unusual melanocytic lesion associated with eccrine duct fibroadenomatosis and syringoid features

The intimate association of nevomelanocytic nevi with eccrine ducts commonly seen in congenital nevi was emphasized by Mishima, who described as eccrine-centered nevi those lesions characterized by nevomelanocytic cells predominantly proliferating around and within the eccrine sweat duct walls. However, there were no changes in the overlying epidermis, dermis, or eccrine acrosyringeal or dermal duct proliferation in these lesions. We present the case of a 16-year-old boy with a 1-year-history of a 0.6-cm diameter single tan papule on the right heel, clinically thought to be a Spitz nevus. Histopathologic examination revealed a compound nevomelanocytic nevus associated with epidermal hyperplasia, thin anastomosing cords of acrosyringeal epithelium extending within the dermis, and eccrine ductal proliferation in a syringoma-like pattern associated with a dense fibrous stroma. Features that distinguish our case from eccrine-centered nevus are that the latter lacks epidermal and eccrine duct hyperplasia and a dense fibrous stroma. The location of the lesion on the heel in our case suggests the possibility that the pathologic changes observed could result from repetitive trauma.