Papillary Poroid Hidradenoma: A Distinct Histopathological Entity A Rare Case Report

Abstract

A 34-years-old male presented with a mass over the right chest wall, below the nipple, of 18 months duration. Physical examination revealed a tense, cystic, painless swelling of size, 5 cm. Transillumination was positive. Chest ultrasound revealed a heterogeneous mass with anechoic and cystic components, with mild vascularity. CT-scan showed a subcutaneous mass which presented dual solid and cystic components. A clinical diagnosis of a cyst with malignancy was suspected. A total surgical excision was performed and the mass was submitted for a histolopathologic examination.Gross examination revealed a skin covered, well-circumscribed, fluctuant mass which measured 5cmx5cm×3cm. The cut surface showed a variegated appearance with a multilocular cystic lesion which was filled with mucoid cloudy fluid and solid papillary areas. The multilocular cystic areas showed intracystic papillary fronds of tumour. The tumour was greyish white in appearance. The lower border revealed subcutaneous fat. The stretched shiny skin on the external surface and around the tumour did not reveal hair [Table / Fig-1A,1B]. Histology revealed a well-circumscribed, solid-cystic Pathology Section aBstRaCt Papillary poroid hidradenoma is a very rare entity which belongs to poroid neoplasms, which represents 10% of sudoriferous tumours. It can be easily misdiagnosed as a malignant neoplasm. A 34-years-old male presented with an asymptomatic mass over the right chest wall, below the nipple, of 18 months duration. Clinical examination revealed tense cystic swelling which revealed hypoechoic and solid components on imaging. Clinically, a malignancy was suspected and a surgical excision was done. Histology and immunoreactivity to pan cytokeratin, epithelial membrane antigen and carcino-embryonic antigen confirmed the diagnosis. We are reporting this case because of the rarity of its presentation.

Poroid Hidradenoma: Case Report and Comprehensive Review of the Literature

“…PH is thought to be a benign cutaneous neoplasia with low (<1%) risk of malignant transformation [ 32 ]. However, complete surgical excision remains the standard treatment due to possible advancement of pathology from a benign eccrine poroma to eccrine porocarcinoma [ 39 – 41 ] or development of carcinomatous changes to hidradenocarcinoma [ 42 ], as well as to prevent recurrence, and due to its common misdiagnosis for malignant subcutaneous neoplasms.…”

Anal Poroid Hidradenoma: Case Report

“…Poroid hidradenomun papiller poroid hidradenom subtipi de bildirilmiştir. 3 Poroid hidradenom tanısı, doku örneğinin histopatolojik incelenmesi temeline dayanmaktadır. İmmunohistokimyasal çalışmalarda, diğer poromalar ile benzer boyanma paternine sahip olduğu gösterilmiştir.…”

“…İmmunohistokimyasal çalışmalarda, diğer poromalar ile benzer boyanma paternine sahip olduğu gösterilmiştir. 3,6 Olgumuzda histopatolojik bulgular ile deri eki tümörü düşünülmekle birlikte, hüc-relerin dar sitoplazmalı ve uniform görünümde olması, ayırıcı tanıda karsinoid tümör ve malign melanomu ekarte etmeyi gerektiriyordu. Poroid hidradenomlarda immünohistokimyanın ayırıcı tanıda yardımcı olabileceği lezyonlar arasında bazal hücreli karsinom, malign melanomun yanı sıra nö-roendokrin tümör metastazları bulunmalıdır.…”

“…Ayrıca göğüs duvarı, aksilla, abdomen ve vulva yerleşimi de bildirilmiştir. [1][2][3][4] Olgumuz lezyonun lokalizasyonu ve genç yaşta olması ile diğerlerinden farklılık göstermektedir.…”

“…Fizik muayenede benign neoplazmların yanı sıra birçok malign neoplazma benzerliği nedeni ile tedavide total eksizyon tercih edilmektedir. 1,5 Turkiye Klinikleri J Dermatol 2015;25 (3) 140…”