Giant vascular eccrine spiradenoma presenting as a thrombosed varix

Eccrine spiradenoma is a benign adnexal tumor of the sweat gland. Giant vascular eccrine spiradenoma is a rare variant of eccrine spiradenoma, characterized by its large size and florid vascularity. Its rarity and clinical appearance give rise to typical misdiagnosis as angiomatous lesions. We present a case of a giant vascular eccrine spiradenoma that was initially diagnosed as a thrombosed varix on the basis of clinical presentation and ultrasound features. This case reintroduces this rare condition and also highlights the differential diagnoses of lower limb skin nodules that may masquerade as a thrombosed varix.