Cutaneous Adnexal Tumours in an Eastern European Cohort: Clinicopathological Spectrum and Rare Malignant Lesions

Introduction: Cutaneous adnexal tumours are a heterogeneous group of tumours arising from the adnexal structures of the skin. These include follicular, eccrine, apocrine, and sebaceous lineages. These entities display a wide morphological spectrum with overlapping histopathological features, posing significant diagnostic challenges. This study aims to provide a detailed analysis of these neoplasms. Materials and Methods: We conducted a retrospective observational study including patients with primary cutaneous adnexal tumours diagnosed in excisional specimens at our centre between 2018 and 2025. Results: A total of 82 primary cutaneous adnexal tumours were analysed in patients aged 24-90 years. A female predominance was observed (62.19%), with a mean age of 56 years among female patients and 60 years among male patients. The head and neck region was the most frequently affected site (70.73%), followed by the upper limb, thorax, and lower limb. Sweat gland tumours markedly outnumbered follicular tumours (79.27% vs. 20.73%), with hidrocystomas and spiradenomas representing the most common benign lesions. Most tumours were benign (91.46%), while atypical spiradenoma (3.66%) and malignant tumours such as eccrine porocarcinoma, trichilemmal carcinoma, and basal cell carcinoma arising in association with trichoblastoma (4.88%) were rare but clinically significant findings. Surgical specimen volumes varied significantly by anatomical site, with scalp and limb lesions reaching the largest dimensions. Margin status differed according to biological behaviour, with malignant tumours showing greater proportion of close or infiltrated margins, while margins were non-assessable in all three atypical cases. Immunohistochemical evaluation supported diagnostic confirmation in atypical and malignant cases. Conclusions: Our findings highlight the broad clinical and morphological spectrum of cutaneous adnexal tumours and contribute data from an Eastern European cohort. This study adds regional data to the limited literature on the clinicopathological distribution of cutaneous adnexal tumours and emphasises rare, atypical, and malignant diagnostic scenarios.