http://www.histopathology-india.net/SwCa.htm

   

     Site created by

 Dr Sampurna Roy MD

http://www.histopathology-india.net/dermpath.htm

Cysts:

Hydrocystoma -Eccrine/Apocrine

Hamartomas:

Eccrine/Apocrine naevus

Eccrine Angiomatous Hamartoma

Porokeratotic eccrine ostial naevus

Benign Neoplasms:

Syringocystadenoma Papilliferum

Hidradenoma Papilliferum

Nipple Adenoma

Syringoma

Spiradenoma

Cylindroma

Chondroid Syringoma (benign mixed tumour)

Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringofibroadenoma

Spiradenocarcinoma is a rare dermal appendage carcinoma believed to arise from transformation of a long-standing benign spiradenoma.

It is an exceedingly rare malignant neoplasm with ductal differentiation.

The tumour was first described by Dabska in 1972.

This tumour demonstrates highly malignant biologic behavior with a high recurrence rate, frequent lymph node metastases , and overall poor survival.

Many consider it to be an eccrine neoplasm, and others favour apocrine differentiation.

Clinical presentation:  Usually there is a history of increase in size of the mass, change in colour or ulceration of the overlying skin.  Size of the lesion ranges between  0.5–15 cm.

Site:  Most lesions usually arises on the lower extremities  and rarely on the trunk. 

Microscopic features:   

There are two distinct components, typical spiradenoma and carcinoma with areas of transition ; Tumour displays monotonous basaloid cells with occasional ductular differentiation ; Luminal aspect of the tumour cells stain positively with PAS ; Tumour infiltrates into the deep dermis and extends into the subcutaneous fat ;  Focal areas of necrosis and mononuclear reactive inflammatory cell infiltration.

Immunohistochemistry: Tumour cells express cytokeratin , epithelial membrane antigen and p53.

Differential diagnosis:

Merkel cell carcinoma : Immunohistochemical stains are performed (low molecular weight cytokeratin, neurofilament, chromogranin, neuron specific enolase and EMA).  In malignant spiradenoma the tumour cells show diffuse cytoplasmic staining with cytokeratin.

The clinical course is characterised by local recurrences and metastasis.
The usual sites of metastasis are regional nodes ,bone, lung and liver.

Spiradenocylindrocarcinoma: a malignant hybrid tumor. J Cutan Pathol. 2005;32(6):453.

Spiradenocarcinoma of the breast arising in a long-standing spiradenoma. Ann Diagn Pathol. 2004;8(3):162-6.

Malignant eccrine spiradenoma: a case report with pulmonary metastasis. Pathol Int. 2004;54(3):208-12.

External auditory canal eccrine spiradenocarcinoma: a case report and review of literature. Head Neck. 2003;25(6):505-10.

Linear spiradenoma with focal malignant transformation. J Eur Acad Dermatol Venereol. 2003;17(3):308-12.

Malignant eccrine spiradenoma. Arch Pathol Lab Med. 2002 ;126(5):591-4.

Spiradenocarcinoma of the scalp. Cutis. 2002;69(6):455-8.

Eccrine spiradenocarcinoma with unusual histiocytic giant cell components. Case report and review of the literature of a rare sweat gland tumor.Pathologe. 2002 Mar;23(2):149-55.

De novo malignant eccrine spiradenoma with an interesting and unusual location.Dermatol Surg. 2001 Apr;27(4):417-20.

Carcinomas of sweat glands: report of 60 cases.Arch Pathol Lab Med. 2001;125(4):498-505.

Malignant eccrine spiradenoma: a case report and review of the literature.Dermatol Surg. 2001 Mar;27(3):324-5.

Malignant spiradenoma: report of two cases and literature review.J Am Acad Dermatol. 2001 Feb;44(2 Suppl):395-8.

p53 expression in two cases of spiradenocarcinomas.Am J Dermatopathol. 2000;22(2):104-7.

Malignant eccrine spiradenoma (spiradenocarcinoma). A clinicopathologic study of 12 cases. Am J Dermatopathol.  2000 ; 22 : 97-103.  

Malignant eccrine spiradenoma: a previously unreported presentation and review of the literature.Am Surg. 1999 Mar;65(3):236-40.

Malignant eccrine spiradenoma with carcinomatous and sarcomatous elements.J Clin Pathol. 1997;50(10):871-3.

Malignant eccrine spiradenoma with smooth muscle cell differentiation: histological and immunohistochemical study.Pathol Int. 1996;46(11):887-93.

Overexpession of p53 protein as in indicator of the malignant transformation in spiradenoma. Histopathology 1995 ; 26 : 439-443.

Carcinosarcoma arising in eccrine spiradenoma. A morphologic and immunohistochemical study.Ann Pathol. 1994;14(3):168-73.

Malignant eccrine spiradenoma. A clinicopathologic study. Am J Dermatopath.1992 ;14: 381--390   

The potential malignancy of eccrine spiradenoma.Ital J Surg Sci. 1989;19(3):265-8.

Sweat gland carcinoma ex eccrine spiradenoma. Am J Dermatopathol. 1987 ; 9 : 90-98. 

Malignant transformation of eccrine spiradenoma. Arch Dermatol 1985 ; 121: 1445-1448