The first Japanese case of alveolar hydatid disease with cutaneous-subcutaneous lesions is reported. The patient, a 58-year-old man who developed an indurated subcutaneous tumor on the right side of the abdomen, had had partial hepatectomy of the right lobe for echinococcosis thirteen years earlier. Clinically, the tumor was adherent with a fistulosis communication to deeper structures. Histopathologically, multiple PAS-positive cuticular layers with foreign body granulomas and fibrosis were observed between the dermis and subcutaneous fatty tissue. Surgical excision of the swelling provided the patient with temporary relief. To our knowledge, only eight cases of subcutaneous alveolar hydatid disease have been reported throughout the world. Ours, the ninth case, highlights the importance and difficulty of treating of alveolar hydatid disease.
Papillary eccrine adenoma (PEA) is a rare cutaneous tumor which histopathologically presents numerous intradermal tubular structures with inward papillary projections. Only a few cases of PEA have been reported recently. We report a case of PEA of a 58-year-old Japanese man. The marked hyperkeratosis and pits gave the tumor the clinical appearance of a burst-open pomegranate. Compact hyperkeratosis within proliferated epidermis contained spiral ducts mimicking intraepidermal eccrine sweat ducts histopathologically. These keratinous structures were thought to correspond to the pores. Several tubular structures running up to the overlying thickened epidermis were observed in the upper dermis. With these findings and with immunohistochemical studies, we proposed that this tumor originated from eccrine sweat ducts.
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