A weeping tumor in a young girl: An unusual presentation of nodular hidradenoma

Abstract

A 10-year-old girl presented with a swelling on her left thigh that was associated with dripping of serous fluid from the lesion. Based on histological features of the excised tumor, a diagnosis of nodular hidradenoma was made. Atypical features including large size of the tumor, location on the lower limb, a weeping presentation, and histological finding of a nodular hidradenoma with an unusually large cystic cavity discharging fluid prompted us to report the case.

Hard nodules over the foot

“…Nodular hidradenoma, also called hidradenoma, clear cell hidradenoma, eccrine acrospiroma, eccrine sweat gland adenoma, clear cell myoepithelioma, or solid-cystic hidradenoma is an uncommon benign adnexal tumor originating from the distal excretory duct of the sweat glands. [ 1 ] The disease is usually seen in 20–50 years of age and is two times more frequently seen in females. They are solid or cystic in consistency, enlarge slowly, and are referred to as giant hidradenoma when skin changes such as ulceration and colur changes are evident.…”

“…Immunohistochemistry shows staining of tumor cells with antibodies against smooth muscle actin, vimentin, S-100, epithelial membrane antigen, p63, BER-EP4, and CK-CAM 5.2. [ 1 ]…”

Solitary nodule on the thigh

“…[ 4 ] Immunohistochemistry shows positive staining with antibodies against cytokeratin-CAM 5.2, Ber-EP4, p63, epithelial membrane antigen, S-100 protein, smooth muscle actin, and vimentin. [ 2 3 4 ]…”

Clarion and Crystal-Clear Cell Hidradenoma

“…Clear cell hidradenoma necessitates a distinction from a concordant lesion such as haemangioma, glomus tumour, cutaneous lymphoma, dermatofibrosarcoma protuberans, leiomyoma, follicular cyst, trichilemmoma or adjunctive sweat gland or adnexal tumours which are clinically indistinguishable [9,10]. Clear cell neoplasm confined to the dermis necessitate a segregation from metastatic malignancies and primary skin tumours with follicular, sebaceous and sweat gland differentiation.…”

“…Clear cell hidradenoma in adults require a demarcation from metastatic renal cell carcinoma. However, nodules of hidradenoma are devoid of the classic pulsating vascular prominence as delineated in malignant deposits of renal cell carcinoma [10,11]. Although clear cell hidradenoma, also termed as eccrine acrospiroma, is predominantly a benign neoplasm, the nodules can be subjected to malignant transformation.…”