Adnexal Tumors Research Articles

Cutaneous balloon-cell melanoma metastases to the axillary lymph node: Exploring cytomorphologic features and differential diagnoses on fine needle aspiration biopsy.

Balloon cell melanoma (BCM) is an exceptionally uncommon histological variant, making up <1% of all malignant melanomas. Diagnosing balloon cell melanoma on cytological specimens can be challenging due to its scarcity and its similarity to other medical conditions. A comprehensive clinical assessment and histological analysis, coupled with immunohistochemical staining, play a crucial role in distinguishing balloon cell melanoma from various benign and malignant skin conditions. The differential diagnoses encompass spitz nevus, balloon cell nevus, clear cell sarcoma of tendons and aponeuroses (melanoma of soft tissues), metastatic clear cell renal cell carcinoma, sebaceous carcinoma, and benign adnexal tumours like clear cell hidradenoma. Malignant melanoma encompasses a spectrum of histopathological subtypes, each with unique clinical and cytological characteristics. Notably, balloon-cell melanoma (BCM) emerges as an exceptionally rare and diagnostically challenging variant. Marked by the presence of distinct balloon-like, clear cytoplasmic vacuoles within melanoma cells, BCM stands apart from other melanoma subtypes. Despite its rarity, the distinctive cytological features of BCM make it a compelling subject of investigation, emphasizing the crucial role of Fine Needle Aspiration (FNA) cytology in ensuring accurate diagnosis and guiding subsequent management decisions.

Five-year pattern of adnexal tumors of the skin in Ethiopia.

Adnexal tumors of the skin are rare neoplasms that encompass a wide range of dermatologic entities. Here, we investigated the pattern of adnexal tumors of the skin in the All African Leprosy and Tuberculosis Rehabilitation and Training Center (ALERT) hospital retrospectively. A hospital-based retrospective study was conducted at ALERT from histopathology records in the Armauer Hansen Research Institute (AHRI) pathology laboratory of patients diagnosed with any of the skin adnexal tumors during the time period January 2017 to December 2021. A structured data extraction sheet was used. Data entry was done using EpiData 4.6.0.6. Data were analyzed using SPSS version 25. A total of 146 skin adnexal tumors were identified making the magnitude 2.8% of total biopsies. The 3rd decade of life was found to be the most common age group. Male-to-female ratio was 1 : 1.05. Majority of the tumors were benign (82.2%) and had sweat gland differentiation at 48.6%. Poroma (10.9%) was the most frequent tumor, whereas porocarcinoma (6.8%) made up the most frequent malignant tumor. The most common site was the head and neck region (48.6%). Only 21.2% of the tumors were correctly identified clinically. The magnitude of skin adnexal tumors is found to be slightly higher than other similar studies which could be because it was carried out in the largest dermatologic center in the country. The most common skin adnexal tumors identified, their localizations, and lines of differentiation are all in line with other studies. Histopathologic examination is mandatory for the accurate diagnosis of these tumors.

Role of Cytology for Diagnosis of Appendageal Tumours and Comparison with Histopathology: A Cross-sectional Study

Introduction: Skin adnexal neoplasms are quite rare in routine pathology practice, yet the domain of Fine Needle Aspiration Cytology (FNAC) remains relatively unexplored. This current study explored different Adnexal Tumours (ATs) through FNAC, emphasising the efficacy of cytological diagnosis as a safe, simple, quick, and cost-effective tool with high sensitivity and specificity for diagnosing skin ATs. Aim: To diagnose various appendageal tumours through cytological examination, confirm and categorise them (benign/ malignant) via histopathological examination, and identify any cytohistological discrepancies. Materials and Methods: This retrospective cross-sectional study was conducted over a five-year period (January 2016- December 2021) at the Department of Pathology, Nil Ratan Sircar Medical College and Hospital (NRSMCH) in Kolkata, West Bengal, India, following ethical approval. Patients underwent history and physical examination followed by FNAC. ATs were diagnosed cytologically in 78 out of 23,852 FNAC cases. The results were compared with histopathological diagnosis to assess concordance or discordance based on predefined criteria. Leishman-Giemsa (L&amp;G) stain was used for cytological examination, and Haematoxylin and Eosin (H&amp;E) stain for histopathology. Results: Cytologically, ATs were diagnosed in 78 cases (0.33%), with the majority being benign 69 (88.46%). There was a female preponderance (49, 62.82%) with a male-to-female ratio of 1:1.7. Nodular Hidradenoma (NH) was the most common diagnosis (16/48=33.33%). Out of 59 biopsy-confirmed lesions, 55 showed cytohistological concordance (93.22%), with only four discordant cases (6.78%). The sensitivity, specificity, positive predictive value, and negative predictive value for detecting malignancy in this series were 70%, 97.90%, 87.50%, and 94.10%, respectively. Conclusion: FNAC should be the primary choice for detecting skin ATs due to its safety, reliability, high predictive value, and low chance of discordance. Although occasional cytohistological discrepancies may occur, proper clinical correlation, aspiration from multiple sites, expert cytopathologists, and high-quality staining are essential to avoid misdiagnosis.

Clinical and Histomorphological Features of Cutaneous Adnexal Neoplasms: A Series of Eighteen Cases

Cutaneous Adnexal Neoplasms (CAN) are rare skin tumours with varied morphology that are often misdiagnosed clinically. The definitive diagnosis of these tumours can only be made by Histopathology (HP) based on their appendage differentiation. Though rare in occurrence, diagnosing these tumours is of prime importance, as they can mimic primary cutaneous carcinomas, cutaneous metastasis of a primary tumour, or can serve as markers of internal malignancy. Excision is mostly curative in benign tumours, and wide local excision needs to be performed to prevent recurrences. The aim of the present case series study was to investigate the histopathological spectrum of different CANs based on their appendage differentiation in a hospital-based study. A retrospective analysis was conducted over a period of 4.5 years, and all CAN cases diagnosed on HP were classified according to their appendage differentiation. The concordance between histopathological diagnosis and clinical diagnosis was calculated. Additionally, the frequency distribution of CAN in relation to demographic data was analysed. In the present case series, 18 cutaneous adnexal tumours were reported, showing a female predominance. The majority of the tumours 12 (66.67%) cases were observed in the head and neck region and exhibited a predominance of sweat gland differentiation 12 (66.67%) cases. The most common CANs were eccrine spiradenoma and pilomatrixoma, with 3 (16.67%) cases each. Sebaceous carcinoma and a rare case of Malignant Proliferating Trichilemmal Tumour (MPTT) accounted for 2 (11.11%) cases, being the only malignant tumours reported. The present study demonstrated only concordance of 4 (22.22%) cases between clinical and HP diagnosis. Therefore, the present series emphasises the importance of appendage differentiation in HP, which plays a crucial role in the definitive diagnosis, treatment planning and prognosis in CAN.

Histomorphological Patterns of Skin Adnexal Tumours in a Tertiary Care Centre, Chhattisgarh, India: A Cross-sectional Study

Introduction: Histologically, tumours of the epidermal appendages have been classified into four groups that exhibit histologic features analogous to hair follicles, sebaceous glands, apocrine glands, and eccrine glands. Aim: To investigate the histomorphological spectrum and distribution of Skin Adnexal Tumours (SATs). Materials and Methods: This observational descriptive crosssectional study was conducted over a period of five years, from August 2017 to July 2022, in the Department of Pathology at Pt. JNMMC Raipur, Chhattisgarh, India. All histologically diagnosed cases of SATs in the pathology department during this period were included, along with relevant data such as age, sex, anatomical location of tumours, and clinical diagnosis. Results were presented in the form of frequency distribution in terms of numbers and percentages. Results: Out of a total of 51 SATs, the male-to-female ratio was 1:1.3, indicating a female preponderance. The highest number of cases was observed in the age group of 41-60 years, comprising 17 cases (33.3%). Benign tumours accounted for 35 cases (68.63%), while malignant tumours comprised 16 cases (31.37%). Tumours associated with hair follicles were the most common, with 25 cases (49.02%). The head and neck region was the most common site for SATs, comprising 30 cases (58.82%). Pilomatrixoma was the most common benign SAT, constituting 13 cases (25.49%). Among malignant SATs, sebaceous carcinoma was the most prevalent, comprising seven cases (13.73%). Conclusion: SATs present a diagnostic challenge for both clinicians and pathologists due to their diverse clinical presentations and overlapping histopathological features. While most SATs are benign, their malignant counterparts, although rare, have an aggressive course with metastatic potential and poor outcomes. Therefore, early detection of malignant SATs is crucial. Present study emphasised that histopathological examination is the gold standard for establishing early diagnosis and enabling appropriate therapeutic intervention.

Case of Malignant Proliferating Trichilemmal Tumour in Gluteal Region

Malignant Proliferating Trichilemmal Tumour (MPTT) is a rare, malignant cutaneous adnexal tumour that originates from the outer root sheath cells of the isthmus of hair follicles. This article aims to report a rare case of a high-grade malignant trichilemmal tumour arising in the context of a proliferating Trichilemmal Cyst (TC) in a 65-year-old female who presented with a painless swelling in the left gluteal region that had been present for two months. There have been only about 100 cases reported so far. Both the clinical features and the imaging findings were suggestive of an ostensibly benign lesion. As a result, the cyst was excised; however, further histopathological evaluation revealed an unexpected case of rare MPTT. Consequently, a timely second revision surgery was performed to ensure tumour-free margins. This case illustrates that the diagnosis of MPTT is highly challenging. Without prior knowledge and a high index of suspicion, the diagnosis of MPTT could easily be missed. MPTT is often misdiagnosed as a variant of Squamous Cell Carcinoma (SCC). The subtle nuances of the unique histopathological pattern of MPTT can help differentiate it from SCC.

Malignant Eccrine Tumours at Unusual Locations: A Report of Two Cases

Eccrine carcinoma is a rare skin adnexal tumour that presents significant diagnostic challenges due to its uncommon occurrence and varied clinical presentations. This report discusses two unique cases of eccrine carcinoma in middle-aged females, occurring at atypical locations: the thigh and the anal region. It emphasises the importance of recognising such tumours for appropriate management. The first case describes a 53-year-old woman with a chronic, non healing thigh ulcer that was initially suspected to be a benign lesion but was later identified as spiradenocarcinoma through histopathological examination. This highlights the potential for benign eccrine lesions to undergo malignant transformation. The second case involves a 50-year-old woman presenting with rectal bleeding and a malignant growth at the anal verge, which was confirmed as eccrine carcinoma through comprehensive pathological analysis, including immunohistochemical staining. Both cases underline the crucial role of detailed clinical observation and advanced histopathological evaluation in diagnosing and managing eccrine carcinoma, particularly when presented in non traditional sites. This approach guides effective treatment strategies and improves patient outcomes.

Artificial intelligence and machine learning a new frontier in the diagnosis of ocular adnexal tumors: A review.

In our article, we explore the transformative potential of Artificial Intelligence and Machine Learning in oculo-oncology, focusing on the diagnosis and management of ocular adnexal tumors. Delving into the intricacies of adnexal conditions such as conjunctival melanoma and squamous conjunctival carcinoma, the study emphasizes recent breakthroughs, such as Artificial Intelligence-driven early detection methods. While acknowledging challenges like the scarcity of specialized datasets and issues in standardizing image capture, the research underscores encouraging patient acceptance, as demonstrated in melanoma diagnosis studies. The abstract calls for overcoming obstacles, conducting clinical trials, establishing global regulatory norms and fostering collaboration between ophthalmologists and Artificial Intelligence experts. Overall, the article envisions Artificial Intelligence's imminent transformative impact on ocular and periocular cancer diagnosis.

Разработка нового нанобиотехнологического метода и его применение для дифференциальной диагностики опухолей придаточного аппарата глаза

Aim: to develop a new nanobiotechnology method for the differential diagnosis of ocular adnexal tumors. Patients and Methods: 192 eyelid or conjunctival tumor samples from 192 patients were examined. Controls were healthy tissue samples from the same eye. To register and obtain significant differences in the generation of biogenic silver nanoparticles in situ, the key parameters of the reaction of the reduction of silver cations were selected and optimized. To generate de novo biogenic silver nanoparticles, tissue samples were placed in a sterile solution of a cation source in aseptic conditions. Nanoparticles were generated in situ using a sterile solution of Tollens' reagent (Ag(HN3)2NO3). Results: the optimal parameters of a new nanobiotechnology method were established to conduct the reduction reaction to generate biogenic silver nanoparticles. The required concentration of Tollens' reagent (source of cations) was 63 μg/ml. The wavelength used to observe the de novo generation of biogenic silver nanoparticles (λ) was 410 nm. Obtaining the most significant changes in the optical density of the reaction mixture with biogenic nanoparticles required 10 to 20 min, although the first changes were documented starting from the 5th minute of the reduction reaction. Benign and malignant tumors are characterized by different metabolic activities, i.e., benign eyelid and conjunctival tumors reduce cations more slowly than malignant tumors. The parameters of reducibility of benign ocular adnexal tumors did not significantly differ depending on tumor location and type. Among the malignant conjunctival tumors, melanoma is characterized by the highest reducibility p&lt;0.05). Among the malignant eyelid tumors, no significant differences were found for different tumor types. Conclusions: this novel nanobiotechnology method provides a differential diagnosis of benign and malignant ocular adnexal tumors. The practical relevance of this method lies in differentiating benign and malignant tumors to schedule management strategies and surgical interventions. KEYWORDS: tumor, eyelids, conjunctiva, silver nanoparticles, biogenic synthesis, express diagnostics, ocular oncology. FOR CITATION: Saakyan S.V., Skladnev D.A., Alekseeva A.P., Beznos O.V., Sorokin V.V. Development of a new nanobiotechnology method for the differential diagnosis of ocular adnexal tumors. Russian Journal of Clinical Ophthalmology. 2024;24(1):25–29 (in Russ.). DOI: 10.32364/2311-7729-2024-24-1-5.

Comparison of the value of the GI-RADS and ADNEX models in the diagnosis of adnexal tumors by junior physicians.

To compare the diagnostic effectiveness of the Gynecologic Imaging Reporting and Data System (GI-RADS) and Neoplasias in the Adnexa (ADNEX) model for the diagnosis of benign and malignant ovarian tumors by junior physicians. The sonographic data of 634 patients with ovarian tumors confirmed by pathology in our hospital over 4 years were analyzed retrospectively by junior doctors. The diagnostic efficacy of the GI-RADS and ADNEX models was compared based on pathology. (1) Regarding the diagnostic efficacy of the GI-RADS and ADNEX models, the sensitivity was 90.15% and 84.85%, the specificity was 87.65% and 85.86%, the accuracy rates were 88.17% and 85.65%, and the Youden Indices were 0.778 and 0.707, respectively. The areas under the receiver operating characteristic (ROC) curves were 0.924 (95% CI: 0.900-0.943) and 0.933 (95% CI: 0.911-0.951), respectively. The GI-RADS classification was equivalent to that of the ADNEX model in the diagnosis of adnexal tumors (P>0.05). These findings were highly consistent with the pathological results (Kappa values were 0.684 and 0.691, respectively). (2) When differentiating between different pathological types of adnexal tumors, the ADNEX model had the best diagnostic value for distinguishing between benign tumors and stage II-IV ovarian cancer (AUC=0.990, 95% CI: 0.978-0.997). (1) The diagnostic efficacy of the GI-RADS and ADNEX models in the diagnosis of benign and malignant ovarian tumors by junior physicians is excellent and comparable. (2) The ADNEX model shows good value for differentiating ovarian tumors of different pathological types by junior physicians.

Young Man With Primary Mucinous Cell Carcinoma ofthe Eyelid: 36 Month Follow Up.

Primary cutaneous mucinous carcinoma (PCMC) is a malignant adnexal tumor that masquerades as a benign periocular lesion. We present a case of a 29-year-old male with an eyelid PCMC misdiagnosed as a chalazion. He underwent Mohs microscopic surgery for definitive treatment, with no recurrence at his 36 month follow up. Given the rarity and poorer prognosis in younger patients, a high index of suspicion is crucial for biopsying periocular lesions that fail conservative therapy.

Nodular hidradenoma of eyelid – A rare case with cyto-histo corelation

Nodular hidradenomas is an uncommon benign adnexal tumor that arises as nodules from eccrine sweat glands. Although it can appear at various sites, its occurrence in eyelids is extremely rare. The diagnosis is usually confirmed on histopathology, and the lesion poses a diagnostic challenge for cytopathologist and is rarely diagnosed on fine aspiration needle cytology (FNAC), which prompted us to report. Here we report a rare case of Nodular Hidradenoma in a 50-year male, that was initially diagnosed on FNAC and later confirmed on histopathology and IHC. Thus, our study emphasizes that FNAC can be used as a first line diagnostic modality for nodular lesions of skin.

Relationships between CD34-, CD105- and bcl-2-Expression Levels and Contrast-Enhanced Ultrasound-Based Differential Diagnosis of Adnexal Tumours

The relationships between CEUS parameters of adnexal tumours and postoperative immunohistochemical assessments of CD34, CD105 and bcl-2 were analysed. This study aimed to investigate whether contrast-enhanced ultrasonography (CEUS) parameters depend on the microvascular density of the tumour lesion found after surgery. Fifty-one patients with a diagnosis of adnexal tumours were included in this single-centre, prospective study. Participants underwent preoperative CEUS (contrast-enhanced ultrasound). Colour Doppler enhancement characterisation parameters (Ystart, Ymax and S) were determined. Immunohistochemical examination of histological specimens of the adnexal lesions was then carried out to determine the expression levels of the CD34, CD105 and bcl-2 proteins. Relationships between the aforementioned parameters were investigated. No significant statistical correlations were observed between CD34, CD105 and bcl2 expression levels and CEUS parameters, independently of whether the operated lesion was malignant or benign. Transvaginal CEUS is diagnostic for the detection of pathological neoplastic vascularisation of an adnexal lesion independent of the density of microcapillaries found postoperatively.

Deep learning based histological classification of adnex tumors

BackgroundCutaneous adnexal tumors are a diverse group of tumors arising from structures of the hair appendages. Although often benign, malignant entities occur which can metastasize and lead to patients´ death. Correct diagnosis is critical to ensure optimal treatment and best possible patient outcome. Artificial intelligence (AI) in the form of deep neural networks has recently shown enormous potential in the field of medicine including pathology, where we and others have found common cutaneous tumors can be detected with high sensitivity and specificity. To become a widely applied tool, AI approaches will also need to reliably detect and distinguish less common tumor entities including the diverse group of cutaneous adnexal tumors. MethodsTo assess the potential of AI to recognize cutaneous adnexal tumors, we selected a diverse set of these entities from five German centers. The algorithm was trained with samples from four centers and then tested on slides from the fifth center. ResultsThe neural network was able to differentiate 14 different cutaneous adnexal tumors and distinguish them from more common cutaneous tumors (i.e. basal cell carcinoma and seborrheic keratosis). The total accuracy on the test set for classifying 248 samples into these 16 diagnoses was 89.92 %. Our findings support AI can distinguish rare tumors, for morphologically distinct entities even with very limited case numbers (< 50) for training. ConclusionThis study further underlines the enormous potential of AI in pathology which could become a standard tool to aid pathologists in routine diagnostics in the foreseeable future. The final diagnostic responsibility will remain with the pathologist.

NUT Expression Is of Diagnostic Utility in the Distinction of Digital Papillary Carcinoma From Poroid Hidradenoma.

The distinction between digital papillary adenocarcinoma (DPAC) and benign cutaneous adnexal tumors is clinically important and can be challenging. Poroid hidradenoma frequently occurs at acral sites and can show a number of histological features, which overlap with digital papillary adenocarcinoma. Recent work has shown that YAP1-NUTM1 fusions are frequent in poroid hidradenoma and are associated with nuclear protein in testis (NUT) expression by immunohistochemistry. We evaluated the expression of NUT-1 by immunohistochemistry in 4 cases of DPAC and 4 cases of poroid hidradenoma. Three of 4 cases of poroid hidradenoma showed strong NUT-1 expression, with no staining in any of the cases of DPAC. These results suggest that NUT-1 immunohistochemistry may be a useful additional tool in evaluating this differential diagnosis.

Pazopanib elicits remarkable response in metastatic porocarcinoma: a functional precision medicine approach.

Metastatic porocarcinomas (PCs) are vanishingly rare, highly aggressive skin adnexal tumors with mortality rates exceeding 70%. Their rarity has precluded the understanding of their disease pathogenesis, let alone the conduct of clinical trials to evaluate treatment strategies. There are no effective agents for unresectable PCs. Here, we successfully demonstrate how functional precision medicine was implemented in the clinic for a metastatic PC with no known systemic treatment options. Comprehensive genomic profiling of the tumor specimen did not yield any actionable genomic aberrations. However, ex vivo drug testing predicted pazopanib efficacy, and indeed, administration of pazopanib elicited remarkable clinicoradiological response. Pazopanib and its class of drugs should be evaluated for efficacy in other cases of PC, and the rationale for efficacy should be determined when PC tumor models become available. A functional precision medicine approach could be useful to derive effective treatment options for rare cancers.

A Case of Ovarian Hyperthecosis in a Postmenopausal Woman

Abstract We report a case of a 55-year-old postmenopausal woman who presented with symptoms of fatigue, male pattern hair loss, and hirsutism over 3 years. Investigations showed elevated total testosterone levels of 5.0 nmol/L (1.44 ng/mL; range, 0.3-3.1 nmol/L) using Beckman-Unicel-DXI-800 immunoassay. Testosterone levels were repeated by liquid chromatography-tandem mass spectrometry and were found to be elevated at 7.3 nmol/L (2.10 ng/mL). Estradiol was detectable and free androgen index was elevated. Dehydroepiandrosterone sulfate levels and androstenedione were within normal range, suggesting a nonadrenal source. Computed tomography scan of the abdomen showed no evidence of adrenal or adnexal tumor. GnRH analog stimulation test led to reduction of gonadotrophins and normalization of testosterone within 4 weeks. She had a biopsy of a cranial hair follicle, which showed androgenic alopecia. These investigations confirmed an ovarian source of androgens. Subsequently, she underwent bilateral salpingo-oophorectomy. Histological study of gonadal tissue confirmed the diagnosis of ovarian hyperthecosis. Four weeks after oophorectomy, her testosterone levels normalized and clinical symptoms improved. Ovarian hyperthecosis is a rare cause of hyperandrogenism in postmenopausal women and can pose a diagnostic and therapeutic challenge. Careful history and physical examination along with critical analysis of biochemistry and imaging studies is crucial for correct diagnosis.

Epidemiological and Pathological Profile of Cutaneous Adnexal Tumors, Central Laboratory of Pathological Anatomy and Cytology of Ibn Sina Hospital, Rabat Morocco: Report of 35 Cases

Skin appendix tumors are rare and highly varied tumors. Are mostly benign characters, rarely malignant and dominated from the morphological point of view by their lesional polymorphism. These tumors may present with follicular, apocrine/eccrine, sebaceous and sometimes mixed differentiation, posing diagnostic problems. The aim of this study is to describe the epidemiological profile and the different anatomopathological aspects of this group of tumors and to compare them with data from the literature. We carried out a descriptive study with a retrospective stage, of 35 cases of cutaneous adnexal tumors collected at the service of the Central Laboratory of Pathological Anatomy and Cytology of Ibn Sina Hospital, CHU of Rabat during a period of 3 years, from 2019, 2020 and 2021. The result of this study shows the peak frequency of these lesions, which is located between 60 years and older, occupying 34.2% of all cases; the average age of the patients studied is 41 years and we find the predominance of the female sex which corresponds to 62.9% of the cases; the predilection seat of the lesions is the region of the head and neck, which is occupied by 51.4%; tumor differentiation is divided into apocrine/eccrine which represents 68.6% of cases; follicular in 20% of cases and sebaceous in 11.4% of cases; the most common histological type is poroma 25.7% followed by pilomatricoma 14.2% and papilliferous syringocystadenoma 11.4%; benign tumors are frankly in the majority, occupying 91.5%, against 8.5% of malignant tumors.

Dermoscopic Diagnosis of a Non-Pigmented Skin Tumor: Eccrine Poroma

Dear Editor, Eccrine poroma stands as a benign adnexal neoplasm that originates from the acrosyringium. It typically emerges as solitary, flesh-colored, or erythematous papules, plaques, or nodules, primarily appearing in areas with sweat glands. As well as pigmented lesions, dermoscopy has proven to enhance the clinical diagnosis of numerous non-pigmented skin tumors, including eccrine poroma. Herein we present a case of eccrine poroma located on the dorsal aspect of the left foot, with characteristic dermoscopic features. A 60-year-old woman was admitted with an asymptomatic lesion on the dorsum of her left foot, which had manifested approximately four years before. Clinically, the lesion presented as a well-circumscribed, violaceous, 0.9x0.9 cm papule (Figure 1a). Dermoscopic examination revealed flower-like and leaf-like vascular patterns, white interlacing areas, glomerular vessels, and milky red globules (Figures 1c-d). The lesion was excised and histopathologic findings were consistent with eccrine poroma (Figure 1b). Eccrine poroma (EP) is an adnexal tumor originating in the intraepidermal part of the eccrine sweat gland duct. Dermoscopy and histopathology help to differentiate EP from pyogenic granuloma, seborrheic keratosis, verruca vulgaris, basal cell carcinoma, squamous cell carcinoma, and amelanotic melanoma. Well-defined dermoscopic features in EP are: White interlacing areas around vessels, milky-red globules, flower-like and leaf-like vascular patterns, glomerular vessels, hairpin vessels, yellow structureless areas, poorly visualized vessels, and well-circumscribed globular or lacuna-like structures separated by white to pink mesh bands [1-3]. Histologically, EP manifests as a well-contained tumor constituted of proliferative cuboidal or poroid cells, often extending from the basal epidermis into the dermal layer. Shave, electrosurgical destruction or simple excision may be the treatment of lesions, depending on the depth of the lesion. Kind Regards

A clinico-histopathological study of skin appendageal tumours in a tertiary health care centre in western Odisha– A case series

Skin appendageal tumours (SATs) are those neoplasms that arise from pilosebaceous, apocrine, or eccrine sweat glands. These are a diverse group of tumours with both benign and malignant counterparts. They can be single, multiple, or have a syndromic association with internal malignancies. Benign adnexal tumours are more common, while malignant adnexal tumours are rare, usually locally aggressive, and have the potential for nodal involvement and distant metastasis with a poor clinical outcome. Therefore, proper diagnosis of SATs is important for therapeutic and prognostic reasons.This study aims to determine the clinico-histopathological correlation in cases of SATs in our hospital. It is a case series conducted over a one-and-a-half year period from January 2021 to July 2022. All clinically suspected cases of SATs were examined, biopsied, and subjected to histopathological examination. Histopathologically confirmed cases of SATs were finally analysed. Among twenty-four thousand two hundred twenty-four new patients attending OPD, 30 suspected cases of ATs underwent histopathological examination. Histopathology was confirmatory in only 12 cases (40%). 10 cases were benign, and two were malignant. Out of 10 benign cases, hidradenoma was noted in 3 (25%), trichoepithelioma in 2 (16%), proliferating pilar tumour, apocrine hidrocystoma, steatocystoma multiplex, hidradenoma papilliferum, and pilomatrixoma were seen in one each. Females (75%) outnumbered males (25%) in our study population.: SATs are infrequent and are not frequently observed in the field of surgical pathology. Histopathology is the gold standard for diagnosis.