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Pathology of Spiradenoma

Dr Sampurna Roy MD

Dermatopathology Quiz Case 186

Diagnosis : Spiradenoma

January 2016

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 Paget’s disease

Intermediate grade:


Digital papillary adenocarcinoma

High grade:


Apocrine adenocarcinoma

Eccrine ductal carcinoma


Malignant cylindroma


Sebaceous tumours

Fordyce's Spots


Nevus Sebaceous

Folliculosebaceous Cystic Hamartoma

Sebaceous Hyperplasia


Sebaceous Adenoma

Sebaceous  Carcinoma

Tumours of the Hair Follicle

Hair Germ Differentiation:


Desmoplastic  Trichoepithelioma



Cutaneous  lymphadenoma

Infundibular differentiation:


Dilated Pore of Winer

Pilar Sheath Acanthoma


Spiradenoma is a benign dermal tumour occuring in adults.

This lesion often coexists with cylindromas.

Clinical presentation:

Usually presents as a painful or tender solitary nodule (less than 1cm in diameter).

May occasionally present as multiple lesions .

Giant variants, linear or zosteriform distribution have also been reported. 

Site:  Head and neck, sometimes on the scalp and on the trunk. Rarely on the extremities.

Microscopic features: 

Tumour consists of sharply demarcated lobules located in the dermis without connection to the epidermis ; 

Eosinophilic PAS positive basement membrane-like material may be present around the lobules ; 

Two cell types are present ; Small cells with dark nuclei are present at the periphery and the large paler cells are at the centre ;

Cells are arranged around small lumina ; 

Lumina contains small amounts of granular eosinophilic material that is PAS- positive and diastase resistant ;

Numerous small lymphocytes are present throughout the tumour lobules.

Tumour may show prominent degenerative changes, fibrosis and cyst formation ;

Ancient changes (dilated vessels rimmed by sclerosis) ; 

Larger tumours are partially or totally necrotic ; 


Strands of cells are cytokeratin positive and lumina are CEA positive.

Malignant transformation of spiradenoma (Spiradenocarcinoma) may occur in rare cases.

Brooke-Spiegler syndrome is a rare, autosomally dominant disease characterized by the development of multiple cylindromas, trichoepitheliomas, and occasional spiradenomas.


Further reading:

Infiltrative Recurrent Eccrine Spiradenoma of the Anterior Neck Treated Using Mohs Micrographic Surgery.

Painful eccrine spiradenoma containing nerve fibers: a case report.

Neonatal spiradenoma.

Pediatric segmental eccrine spiradenomas: a case report and review of the literature.

Giant vascular eccrine spiradenoma.


A rare case of multiple segmental eccrine spiradenomas.

Alteration of the β-catenin pathway in spiradenoma.

Eccrine spiradenoma arising in the breast misdiagnosed as an epidermal inclusion cyst.

Differential considerations of skin tumours with florid vascularisation: report of a solitary giant vascular eccrine spiradenoma.

Multiple vascular eccrine spiradenomas: a case report and published work review of multiple eccrine spiradenomas.

A case of eccrine spiradenoma in a patient with neurofibromatosis.

Eccrine spiradenoma with chondroid syringoma in Blaschkoid distribution.

An unusual case of congenital linear eccrine spiradenoma.

Eccrine spiradenoma: co-expression of cytokeratin and smooth muscle actin suggesting differentiation toward myoepithelial cells.

Multiple linear spiradenoma with a linear distribution.

Giant vascular eccrine spiradenoma: report of a case with  immuno histochemical study.

Congenital blaschkoid eccrine spiradenoma on the face.  

Brooke-Spiegler syndrome: report of a case with combined lesions containing cylindromatous, spiradenomatous, trichoblastomatous, and sebaceous differentiation.

Two cases of multiple eccrine spiradenoma with linear or localized formation.

Brooke-Spiegler syndrome associated with cylindroma, trichoepithelioma, spiradenoma, and syringoma.

Familial eccrine spiradenoma: a case report and review of the literature.

Multiple eccrine spiradenomas on the hand, forearm and head.

Blaschkoid eccrine spiradenomas.

Multiple linear eccrine spiradenomas with eyelid involvement.

Cell proliferation in skin tumours with ductal differentiation: patterns and diagnostic application.

Multiple eccrine spiradenomas in zosteriform distribution in a child.

Spiradenocylindromas of the skin: tumors with morphological features of spiradenoma and cylindroma in the same lesion: report of 12 cases.

Spiradenoma and dermal cylindroma comparative immunohistochemical analysis and histogenetic considerations. 

Non-epithelial cellular components in eccrine spiradenoma: a histological and immunohistochemical study of 20 cases.

Eccrine spiradenoma: clinical and pathologic study of 49 tumors.


Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


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