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Pathology of Hidradenoma


(Papillary Hidradenoma)

Dr Sampurna Roy MD

Path Quiz Case 26- Case history and images:

Diagnosis: Hidradenoma Papilliferum

Benign Sweat Gland Tumour


 http://www. SwTu.htm

March 2014

Benign sweat gland tumours


Hydrocystoma -Eccrine/Apocrine


Eccrine/Apocrine naevus

Eccrine Angiomatous Hamartoma

Porokeratotic eccrine ostial naevus

Benign Neoplasms:

Syringocystadenoma Papilliferum

Hidradenoma Papilliferum

Nipple Adenoma




Chondroid Syringoma (benign mixed tumour)



Apocrine adenoma

Papillary eccrine adenoma


Malignant sweat gland tumour

Low grade:

Microcystic adnexal carcinoma

Eccrine epithelioma

Adenoid cystic carcinoma

Mucinous carcinoma

Primary extramammary Pagetís disease

Intermediate grade:


Digital papillary adenocarcinoma

High grade:


Apocrine adenocarcinoma

Eccrine ductal carcinoma


Malignant cylindroma

Proliferating Trichilemmal Cyst (Pilar Tumour)

Matrical differentiation:
Pilomatrixoma and Pilomatrix Carcinoma


Benign Sweat Gland Tumour


 http://www. SwTu.htm


Dilated Pore of Winer

Pilar Sheath Acanthoma

Tumour of Follicular Infundibulum

Trichilemmal Carcinoma

Proliferating Trichilemmal Cyst

Cutaneous lymphadenoma 


Hidradenoma papilliferum (papillary hidradenoma) is a benign tumour and was previously regarded as an apocrine tumour.

According to some authors this tumour is a variant of apocrine adenoma with specific features.

Now there is increasing evidence to suggest that it is closely related to the recently described mammary-like anogenital glands. 

Site:  Almost always located in the vulval or perianal regions. Ectopic lesions have been reported on the face, scalp, eyelid, auditory canal and arm.

Clinical presentation: The tumour usually occurs in middle aged women as small nodules (1cm or less in size).

Microscopic features:

Histologically, these are circumscribed solid or partly cystic tumour containing papillary and glandular areas.

There are two types of epithelium -  tall columnar cells with pale eosinophilic cytoplasm and underlying myoepithelial cell layer.

Prominent apocrine changes are noted in areas. 

Mitotic count is occasionally high.

PAS- positive diastase-resistant granules are present in the apices of the large cells.

Differential Diagnosis:  

The differential diagnosis includes adenocarcinoma.


Further reading:

Hidradenoma papilliferum occurring on the nasal skin.

Hidradenoma papilliferum of the vulva: case report and review of literature.

Diagnosis of hidradenoma papilliferum of the vulva on cytologic smears: a case report.

Ectopic hidradenoma papilliferum.

Hidradenoma papilliferum with mixed histopathologic features of syringocystadenoma papilliferum and anogenital mammary-like glands: report of a case and review of the literature.

Pseudocarcinomatous hyperplasia associated with hidradenoma papilliferum.

A giant ectopic hidradenoma papilliferum in a Niger delta region of Nigeria.

Hidradenoma papilliferum presenting as an eyelid mass.

A Composite Neoplastic Lesion of the Vulva With Mixed Features of Fibroadenoma and Hidradenoma Papilliferum Combined With Pseudoangiomatous Stromal Hyperplasia Containing Multinucleated Giant Cells.

Bartholin's abscess arising within hidradenoma papilliferum of the vulva: a case report.

Hidradenoma papilliferum with a ductal carcinoma in situ component: case report and review of the literature.

Non-anogenital (ectopic) hidradenoma papilliferum with sebaceous differentiation: a case report and review of reported cases.J Dermatol. 2006 Apr;33(4):256-9.

Hidradenoma papilliferum with oxyphilic metaplasia: a clinicopathological study of 18 cases, including detection of human papillomavirus.Am J Dermatopathol. 2005 Apr;27(2):102-10.

Hidradenoma papilliferum with mixed histopathologic features of syringocystadenoma papilliferum and anogenital mammary-like glands.J Cutan Pathol. 2004 Sep;31(8):561-4.

Large ulcerated perianal hidradenoma papilliferum in a young female.Dermatol Surg. 2003 Jul;29(7):790-2.

Hidradenoma papilliferum occurring on the chest of a man.
J Am Acad Dermatol. 2003 Feb;48(2 Suppl):S20-1.

Hidradenoma papilliferum of nasal skin. Arch Pathol Lab Med. 2003 Feb;127(2):E86-8.

Vulvar hidradenoma papilliferum. A review of 10.5 years' experience.J Reprod Med. 2000 Aug;45(8):616-8.

Ectopic hidradenoma papilliferum: a case report and review of the literature.J Am Acad Dermatol. 1999 Jul;41(1):115-8. Review

Perianal hidradenoma papilliferum occurring in a male: a case report.Ir J Med Sci. 1998 Jan-Mar;167(1):26-7.

Hidradenoma papilliferum of the upper eyelid arising from the apocrine gland of Moll.Ophthalmology. 1990 Dec;97(12):1593-8.

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Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


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