Apocrine Cystadenoma*

Abstract

Apocrine cystadenoma presents another distinct ciinico-pathological entity among the appendage tumours. Ciinically these smali skin coloured, blue or biack cysts can usually be distinguished from basai cell carcinoma, melanocytic naevus, or a vascular lesion provided the possible diagnosis is borne in mind.Histologically the picture is quite distinct and diagnostic.Apocrine cysfiidenoma is a J-jither rare small cystic tumour occurring •almost exclusively around the face auci neck and should in most cases be diagnosahle clinically. The fact that it occurs on the face and neck where apocrine glands are of regular occui-rence, but few in number, but uot in the axillae or groins wliere they are plentiful, suggests that it may well be a hamartomafouK malformafiou rafher than a true benign tumour. These lesions range in colour from flesh coloured translucent lesions through brown ;and bine to deep l)lack, and iu size usually from 0-5 to 1-0 cms. in diameter.There has been some confuKiou l'egarding the nomenclature of these lesions, which have also l)eeii called hidrocystoma (jMontfort 1962). However, the term hidrocystoma has also been applied to a vesicular eru])tiou, which occurs ou tlie faces of middle-aged women exposed to hot conditions (Robinson 1893), aud which is probably the result of eccrine sweat retention. The name apocrine cystadenoma was ]iroposed by Mehregan (1964) who described •seventeen cases, and he was the (irst to delineate clearly the range of clinical and histological features in these lesions. Two of his cases occuri-ed in associafiou with orgauoid uaevi, which again suggests a hamartomatous origin. The name a])ocrine cystadeiioma has been accejited by Montgomery (1967) and by Sandei'sou (1968), although Lever (1967 uses the term apocrine hidrocystoma. However, the name apocrine cystadenoma indicates that these lesions are benign neoplasms or liamai'tomas rather than sinijile retention •cysts and is preferable. Mehregan sets out the evidence for this very well. Gross (1965) in an electrou microscope study showed that the epithelium of these cysts was similar to ordinary apocrine sweat gland epithelium, but "with some definite, regular, small differences. Shelley ct al (1955) appear to have been tlie first to desci'ibe these tumours, reportiug two skin coloured lesions which they regarded as apocriue retention cysts. Mouffort (1962) •described thi'ee cases of "l)lack hidi'ocystoma'' on the face and drew attention to the importauce of this entity in the differential diagnosis of pigmented lesions on the face. Lund (1957) shows a histological iiliotograph of a typical lapocrine cystadenoma which was considered clinically to be a pigmented naevus.Histologically these lesions show one or more cystic spaces lined by •apocrine type epithelium and with a surrouudiug organized connective tissue •sheath. The height of the epithelium vai'ies in diffei'ent lesions and even in

Apocrine Hidrocystoma

“…Apocrine hidrocystomas in non-Japanese cases, as mentioned above, may exhibit a distinct dark coloration. Such pigmented lesions may be confused with basal cell carcinoma, melanocytic nevi (particularly blue nevi), or even malignant melanoma (20). In contrast, light pigmented lesions, blue, gray, and reddish brown, are commonly seen in the Japanese literature.…”

Pigmented Eyelid Cysts Revisited

“…The majority of eyelid hidrocystomas are clear, milky, or show a bluish discoloration because of the Tyndall effect but clear fluid on lancing, 2,9 whereas eyelid hidrocystomas showing a darker clinical appearance contain pigmented (brown) cyst contents. 11,14,15,17,[26][27][28][29][30][31][32][33] Like typical eyelid hidrocystomas, this group of singular cases of pigmented hidrocystomas did not show a sex, site, or side predilection or more frequent occurrence of multiple cysts. However, it is suspected that closer examination and more precise description of apocrine hidrocystomas would result in detection of a greater number and variety of colored cysts.…”

Apocrine cystadenoma: A long‐standing apocrine hidrocystoma with an adenomatous proliferation

“…Since the introduction of the term "apocrine cystadenoma" in 1964 by Mehregan, there has been a lack of consensus on whether it represents an apocrine cyst or a cystic benign neoplasm of apocrine differentiation. 1 Cases of simple hidrocystomas found in the classic eyelid location have been called apocrine cystadenomas, [1][2][3][4][5][6][7] while large proliferative apocrine cystic lesions found in non-periocular locations have occasionally been called apocrine hidrocystomas. 8,9 An equal number of reports have used the terms hidrocystoma and cystadenoma interchangeably.…”