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Malignant eccrine spiradenoma with florid squamous differentiation

H H Lee1, K G Lee

  • 1Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

Journal of Korean Medical Science
|June 4, 1998
PubMed
Summary

Malignant eccrine spiradenoma (MES), a rare skin cancer, can develop from benign eccrine spiradenoma (ES). This case highlights key diagnostic features of MES arising in a long-standing ES.

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Area of Science:

  • Dermatopathology
  • Oncology
  • Surgical Pathology

Background:

  • Malignant eccrine spiradenoma (MES) is an exceptionally rare cutaneous neoplasm.
  • Only 31 cases have been previously reported in medical literature.
  • This report details an additional case of MES arising from a pre-existing benign eccrine spiradenoma (ES).

Observation:

  • A 54-year-old woman presented with a rapidly growing, tender nodular mass on her right flank.
  • The mass, previously stable for years, measured 2.8 cm and was not attached to the epidermis.
  • Histopathology revealed a lesion with areas of benign ES and malignant transformation.

Findings:

  • The malignant component of the tumor exhibited solid proliferation of large pale cells with significant nuclear pleomorphism, high mitotic activity (12/10 HPF), and loss of basement membrane.
  • Multiple foci of squamous differentiation were noted within the malignant areas.
  • Immunohistochemistry showed differential expression of cytokeratin, S-100, EMA, alpha-smooth muscle actin, and CEA, with occasional p53 nuclear expression in malignant cells.

Implications:

  • This case expands the understanding of MES presentation and histopathological characteristics.
  • Accurate diagnosis of MES is crucial for appropriate patient management and prognosis.
  • Further research into the pathogenesis and molecular alterations of MES is warranted.

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