A case of an eccrine spiradenoma in an elderly patient mimicking an epidermoid cyst

Eccrine spiradenoma is one of the rarest benign adnexal tumors. Its clinical presentation is nonspecific, often necessitating a differential diagnosis with other benign cutaneous tumors, highlighting the crucial role of histological examination. The literature provides limited descriptions of this tumor, particularly in elderly patients, emphasizing the significance of our case. Our patient, a 61-year-old man with no significant medical history, presented with a painless cutaneous lesion on his back that had been progressively enlarging over six years. Clinical examination revealed a subcutaneous nodule with a firm consistency, measuring 2 cm in its largest dimension. Complete excision of the lesion was performed for pathological examination. Clinical findings, combined with histology and immunohistochemistry, confirmed the diagnosis of eccrine spiradenoma. This is a benign tumor of the eccrine sweat glands, rarely reported in the literature, typically presenting as a solitary nodule, sometimes multiple, with its primary clinical feature being paroxysmal tenderness. Early and complete surgical excision serves both diagnostic and therapeutic purposes. In addition to its rarity, the occurrence in an elderly patient and its painless nature make our publication particularly noteworthy. This article reports a case of eccrine spiradenoma identified in an elderly patient initially suspected of having an epidermoid cyst, underscoring the importance of histopathological examination for any cutaneous tumor.