Multiple mucinous and lipomatous variant of eccrine angiomatous hamartoma associated with spindle cell hemangioma: a novel collision tumor?

Abstract

Eccrine angiomatous hamartoma (EAH) is a rare, benign condition characterized histologically by increased numbers of eccrine elements, as well as numerous capillary channels. In most cases, EAH arises as a single lesion; however, multiple variants have been reported. We report a 35-year-old female patient with multiple, sudoriparous, subcutaneous nodules on the right foot, which showed typical histopathological findings of EAH, and vascular components of the tumor consisted of thin-walled dilated vascular spaces intermixed with spindle cells and some histiocytoid endothelial cells representing spindle cell hemangioma (SCH). To our knowledge, the co-existence of EAH with SCH is a novel finding and not yet described.

Eccrine Angiomatous Hamartoma: A Clinicopathological Study of 26 Cases

“…In our case series, the male:female ratio was 1.2:1, similar to literature reports, which claim no gender predominance [3]. The vast majority of our patients had onset at <18 years of age, highly consistent with previous reports [3,4,5,6,7]. Shin et al [7] speculated that the absence of symptoms in those particular patients may lead to late discovery of the lesion and obscure the actual age at onset.…”

A Case of Eccrine Angiomatous Hamartoma Associated with Verrucous Hemangioma

“…It contained vascular components consisting of dilated vessels intermixed with spindle cells 3 . A case of EAH with overlying verrucous hemangioma-like features has been described.…”

Eccrine Angiomatous Hamartoma

“…An estimated 100 occurrences have been reported in the literature with almost 50% presenting at or shortly after birth. 11 Clinical presentation of EAH is somewhat protean with patches, plaques, or nodules ranging in size from 3 mm to 11 cm in diameter and occurring in various shades of bluishbrown, reddish, violaceous, or flesh colored. 9,10 One-third of the cases in our series were not diagnosed until adulthood, exhibiting a higher frequency of adult EAH occurrences than is typically described.…”

“…9 Spontaneous regression of EAH is exceedingly uncommon with only a single report of partial regression. 1,11 Intimately admixed eccrine and capillary-like vascular spaces at the dermal-subcutaneous level serve as typical histologic feature of EAH. Pain and hyperhidrosis may be managed with analgesics and botulinum toxin, respectively.…”

“…Pain and hyperhidrosis may be managed with analgesics and botulinum toxin, respectively. 5,11 In light of the overlapping features that these other lesions share with EAH and their variable clinical presentations, distinction can prove to be difficult even on biopsy and for that reason, some cases are approached descriptively with the need for clinicopathologic correlation. 13 Pulsed-dye and Nd:YAG laser treatments have shown minimal effectiveness.…”