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Presented by Peter Illei, M.D. and prepared by Joseph J. Maleszewski, M.D.
Case 1: 58 years-old woman status post left radical mastectomy and adjuvant chemotherapy/radiation.
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Question 1 of 1
1. Question
Week 388: Case 1
58 years-old woman status post left radical mastectomy and adjuvant chemotherapy/radiation and an intermediate grade angiosarcoma of the left breast skin 3 years prior to the current specimen. Patient now has a left lateral chest wall nodule.images/jjm041309/case1a.jpg
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images/jjm041309/case1e.jpgCorrect
Answer: Eccrine hidradenoma
Histology: none provided
Discussion: The tumor measures 0.7 cm and is well circumscribed but unencapsulated. The tumor cells are arranged in large sheets, small nests and form tubular structures that are lined by flattened and cuboidal epithelium. Areas with clear cell change and squamous differentiation are also noted. The tumor cells have quite uniform nuclei with clear chromatin and small prominent nucleoli. The tumor is positive for mammaglobin and mucicarmine. This staining pattern supports the diagnosis.
Eccrine hidradenomas (aka. clear cell hidradenoma/eccrine acrospiroma) are sweat gland neoplasm that typically has a benign course. They originate from the lower portion of the eccrine duct and form cellular sharply delineated but not encapsulated tumors in the dermis. Within the tumor solid growth pattern dominates, but areas with clear cell change and small tubule formation are also typical. Rare cases with malignant transformation have also been reported. Because of their cellularity they may be confused with carcinomas, vascular tumor or synovial sarcoma. Immunohistochemistry shows that these tumors are cytokeratin positive and also express breast markers.
Incorrect
Answer: Eccrine hidradenoma
Histology: none provided
Discussion: The tumor measures 0.7 cm and is well circumscribed but unencapsulated. The tumor cells are arranged in large sheets, small nests and form tubular structures that are lined by flattened and cuboidal epithelium. Areas with clear cell change and squamous differentiation are also noted. The tumor cells have quite uniform nuclei with clear chromatin and small prominent nucleoli. The tumor is positive for mammaglobin and mucicarmine. This staining pattern supports the diagnosis.
Eccrine hidradenomas (aka. clear cell hidradenoma/eccrine acrospiroma) are sweat gland neoplasm that typically has a benign course. They originate from the lower portion of the eccrine duct and form cellular sharply delineated but not encapsulated tumors in the dermis. Within the tumor solid growth pattern dominates, but areas with clear cell change and small tubule formation are also typical. Rare cases with malignant transformation have also been reported. Because of their cellularity they may be confused with carcinomas, vascular tumor or synovial sarcoma. Immunohistochemistry shows that these tumors are cytokeratin positive and also express breast markers.
