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Calcification and ossification in eccrine mixed tumors: underrecognized feature and diagnostic pitfall.
Rajalakshmi Tirumalae1, Almut Böer
1Department of Pathology, St. John's Medical College, Bangalore, India.
The American Journal of Dermatopathology
|September 5, 2009
Summary
Eccrine mixed tumors are rare skin neoplasms with diverse mesenchymal components, including extensive ossification and calcification. These distinctive tumors differ from apocrine mixed tumors and require careful histopathological evaluation.
Area of Science:
- Dermatopathology
- Oncology
- Histopathology
Background:
- Eccrine mixed tumors are uncommon skin adnexal neoplasms.
- Their full morphological spectrum remains incompletely understood.
Purpose of the Study:
- To characterize the variability of the mesenchymal component in eccrine mixed tumors.
- To differentiate eccrine mixed tumors from their apocrine counterparts.
Main Methods:
- Analysis of 5 skin biopsy cases diagnosed as eccrine mixed tumors.
- Clinical, histopathological, and immunohistochemical assessments (S-100, cytokeratin, EMA, CEA, ER, HER-2).
Main Results:
- Tumors presented as well-circumscribed dermal or subcutaneous nodules.
- The stroma exhibited mucinous and chondroid features with significant calcification and ossification in some cases.
- Immunohistochemistry confirmed epithelial elements and chondroid stromal cells (S-100 positive) and negative results for EMA, CEA, ER, and HER-2.
Conclusions:
- Eccrine mixed tumors are distinct entities, separate from apocrine mixed tumors.
- The epithelial component can be overshadowed by extensive ossification and calcification, impacting diagnosis.
