15148 Spiradenoma arising in the breast of a high-risk breast cancer patient and review of cases over 76 years

Abstract

Spiradenomas stem from eccrine and apocrine glands to form benign tumors. When arising on the breast, nipple, and areola region, spiradenomas can be difficult to differentiate from more worrisome breast masses in patients with a prior history of breast cancer. These cutaneous tumors can be mimicked by a range of adnexal growths and play a role in syndromic conditions. We present a case of a 56-year-old woman with a 20-year slowly enlarging left lower inner quadrant breast mass reviewed on mammography in a high-risk breast cancer patient, which was later excised and diagnosed as a spiradenoma. Spiradenomas can be challenging to diagnose as they can present with similar findings on inexpensive and noninvasive testing. While biopsy is the definitive tool for diagnosis, this is contraindicated in mimickers such as epidermal cysts. To our knowledge, there are only six case reports of breast spiradenomas. We have reviewed the histopathology of this case including stains with periodic acid–Schiff cytokine 5/6 immunohistochemical stain (IHC) carcinoembryonic antigen (CEA) and epithelial membrane antigen IHC, P63 IHC, gross cystic disease fluid protein 15 (GCDFP-15) IHC, and endoplasmic reticulum IHC and summarized all cases of breast spiradenomas and their malignant counterpart spiradenocarcinomas available in the literature over the past 76 years compiling their presentations, histopathologic stains, and imaging findings.