Eccrine spiradenoma occurring in infancy mimicking mesenchymal tumor

Area of Science:

• Dermatopathology
• Pediatric Oncology
• Surgical Pathology

Background:

• Eccrine spiradenoma (ES) is a rare skin adnexal neoplasm, with infantile presentation occurring in less than 1% of cases.
• Infantile ES exhibits distinct histopathologic characteristics, including superficial dermal nodules with immature cells and less distinct dual-cell patterns.
• These tumors can be misdiagnosed as mesenchymal neoplasms in infants and young adults, necessitating careful differential diagnosis.

Purpose of the Study:

• To describe the clinical and histopathologic features of two infantile eccrine spiradenoma cases.
• To differentiate infantile ES from other cutaneous and subcutaneous mesenchymal neoplasms in pediatric patients.
• To discuss diagnostic criteria, including histochemical and immunohistochemical markers, for accurate identification.

Main Methods:

• Case report of two infants diagnosed with eccrine spiradenoma.
• Detailed histopathologic examination of tumor morphology, including cellular patterns and ductule formation.
• Review of differential diagnoses, comparing infantile ES with common mesenchymal neoplasms in infants and young adults.

Main Results:

• The described infantile ES cases showed superficial dermal nodules with immature adnexal epithelial cells.
• Histopathologic features differed from conventional ES, requiring specific diagnostic considerations.
• Differential diagnosis highlighted the importance of histopathology and immunostains to distinguish from mesenchymal tumors.

Conclusions:

• Infantile eccrine spiradenoma is a benign entity but requires complete surgical excision to prevent recurrence.
• Accurate diagnosis relies on recognizing specific histopathologic features and utilizing appropriate immunostains.
• The study speculates that infantile ES may represent congenital hamartomatous growths.