Malignant nodular hidradenoma-inguinal region clinically masquerading as squamous cell carcinoma: a case report

Abstract

Malignant Nodular hidradenoma is an extremely rare aggressive tumour originating from eccrine sweat glands with an incidence of <.001%. So far less than 80 cases have been reported in the literature. It’s known for its local recurrence (50%) and metastasis (60%) and hence early diagnosis and radical treatment is mandatory. But differentiating it from its benign counterparts and other skin tumour mimics is challenging, due to its histopathological similarity & lack of diagnostic immunomarkers. Authors report a case of 65-year-old female who presented with a short 4-month history of rapidly growing ulceroproliferative growth in the right inguinal region with bilateral inguinal node enlargement, associated with pain and discharge. Wedge biopsy of left inguinal lymph node showed malignant cutaneous adnexal tumour deposits, which after excision was typed as malignant nodular hidradenoma. It was confirmed with immunohistochemistry. Patient presented with recurrence 8 months after excision.

Hidradenocarcinoma of the Left Knee in a 55-Year-Old Woman: A Case Report

“…It has been estimated that 6-7% of benign neoplasms will mysteriously convert into malignant tumors [ 9 ]. Contrary to an Indian study that reported men between the ages of 50 and 70 were somewhat more likely to develop hidradenocarcinoma, our female patient, aged 55, developed the disease as a primary instance [ 8 ].…”

“…The majority of individuals with this type of swelling have an asymptomatic clinical course throughout their disease history, with pain and bleeding upon contact as the most prevalent symptoms. These tumors often have a diameter of 1-5 cm [ 8 ]. However, due to the patient’s delayed presentation to the clinical setting, a bigger mass measuring 7-9 cm with overt ulceration was observed.…”

“…Squamous cell cancer, basal cell carcinoma, metastatic clear cell carcinoma of the lungs and kidneys, dermatofibrosarcoma, eccrine porocarcinoma, and eccrine ductal carcinoma were the differential diagnoses under investigation [ 1 , 7 , 8 ]. The histological evaluation of such swellings is crucial to determine the prognosis.…”

“…It carries a poor prognosis due to metastasis to lymph nodes, bones, or visceral organs, and often causes death, with a reported five-year survival rate of approximately 30%. Histopathology remains the gold standard for its diagnosis [ 7 , 8 ]. We describe a case of hidradenocarcinoma presenting as a primary neoplasm on the left popliteal fossa.…”

A 20-Year Retrospective Analysis of Skin Cancers: Comparison of the First and Second Decades

“…Hidradenocarcinoma has an incidence of less than 0.001% (15,16). Because it is so rare, the treatment protocols used are a subject of debate.…”