Clear Cell Hidradenocarcinoma Research Articles

Ancillary immunohistochemical and molecular testing in the classification of cutaneous sweat gland/duct neoplasms: A validation study with emphasis on histomorphologic correlation and pathological diagnosis

Sweat gland neoplasms represent a challenging area of dermatopathology, as they are relatively uncommon and often histopathologically complex. Recent studies have uncovered distinct immunohistochemical and molecular profiles in several sweat gland neoplasms, including digital papillary adenocarcinoma (DPA), papillary eccrine adenoma/tubular apocrine adenoma (PEA/TAA), poroid family tumors (PFT)/porocarcinoma, and clear cell hidradenoma (CCH)/clear cell hidradenocarcinoma (CCHCa). To further evaluate the diagnostic utility of ancillary studies in various sweat gland neoplasms, we performed an independent validation study in a cohort of patients with acral and non-acral tumors (9 DPA, 8 PEA/TAA, 13 PFT, 5 porocarcinoma, 23 CCH, 7 CCHCa, 6 sweat gland carcinoma not otherwise specified). p63 immunohistochemistry (IHC) demonstrated a myoepithelial pattern in 8/8 DPA and 4 of 4 tested PEA/TAA cases, and showed a ductal pattern in all tested PFT/porocarcinoma and CCH/CCHCa cases (42/42). All PEA/TAA (8/8) cases were positive for BRAF V600E IHC. 5 of 12 tested PFT and 5/5 porocarcinoma cases showed either positive staining with NUT IHC or harbored YAP1::NUTM1 fusion gene by RNA sequencing. MAML2 fluorescence in situ hybridization (FISH) was positive in all CCH and CCHCa cases (23/23 and 7/7, respectively). Our results further support the usefulness of appropriate ancillary studies in precise classification of sweat gland tumors, which may be routinely applied in diagnostic pathology practice when morphologic evaluation is in doubt.

Incidence, survival, and prognostic factors associated with malignant nodular hidradenoma in the United States

To the Editor: Malignant nodular hidradenoma (MNH), also known as clear cell hidradenocarcinoma, is a rare sweat gland tumor first described in 1954.1 Lesions may exhibit apocrine and eccrine histological features.2 MNHs have been associated with a tendency for recurrence, metastasis, and high mortality.3 Due to its rarity, the literature on MNH is limited to case reports and small case series. The population-level incidence and outcomes associated with MNH have not been studied.

A Rare Case of Scalp Mass: Clear Cell Hidradenocarcinoma

Clear cell hydroadenocarcinoma is a very rare sweat gland tumor. It has an aggressive course and has a high recurrence rate. Wide excision is the first option in the treatment of this tumor with a high rate of metastasis. Subsequent radiotherapy and chemotherapy are still controversial. In this case, we presented a patient who was operated on and presented with a lipoma-like appearance on the scalp. The pathology result of the patient was Clear cell hidradenocarcinoma. We emphasized that in operations performed with the preliminary diagnosis of lipoma on the scalp, this diagnosis should be included among the preliminary diagnoses and resection should be performed as widely as possible.

Clear Cell Hidradenocarcinoma: a Rare Identity Difficult to Recognize – Case Report and Review of the Literature

Clear Cell Hidradenocarcinoma: a Rare Identity Difficult to Recognize – Case Report and Review of the Literature

Malignant Cutaneous Adnexal Tumor in Posterior Occipital Region of a Child: A Case Report

Introduction: The most common cutaneous adnexal tumors in children were follicular, especially pilomatricoma, and a few were predominant glandular/ductal differentiation, malignant forms are occasionally encountered. Here, a case of a malignant cutaneous adnexal tumor with eccrine differentiation was reported. Case presentation: A 10-year-old male child was presented with a nodular in posterior occipital for half a year with no symptoms. Histopathology showed there was acanthosis in epidermis, partially with local ulceration and crusting; and in the dermis, there was irregular scattered or agglomerated infiltration of diffused epithelial cells, partly presenting as basaloid, but no obvious peripheral palisading arrangement; and in the center there was extensive necrosis; cellular pleomorphism, scattered mitotic figures, focal clear cell areas, and adenoid differentiation can also be seen, there was scattered infiltration of mixed inflammatory cells in the stroma. Immunohistochemistry showed cytokeratin (CK) 5/6+, CK 8/18+, epithelial membrane antigen +, gata3 transcription factor 3+, cell adhesion15 (focal +), Ki67 (+, 30%), carcinoembryonic antigen (focal+), CK 7 (focal+), gross cystic disease fluid protein-15−, P63+, S-100−. Final diagnosis was the malignant cutaneous adnexal tumor with eccrine differentiation, most likely the nodular clear cell hidradenocarcinoma. The patient has no special discomfort follow-up observation after extended resection and lymph node examination. Discussion: The histopathology showed infiltrative growth pattern, deep extension, necrosis, nuclear pleomorphism, mitoses, desmoplastic stromal reaction and the clear cell area and adenoid differentiation. Immunohistochemistry was positive for CK8/18, EMA, CK5/6, P63, gata3 transcription factor 3 and negative for S-100 and GCDFP-15, some gland-derived markers such as CK7, CEA were focal positive, and we have not found the preexisting benign poroma and porocarcinoma in situ, so we preferred the diagnosis of hidradenocarcinoma. The differential diagnosis such as porocarcinoma, clear cell squamous cell carcinoma, and basal cell carcinoma were taken into account. Conclusion: The diagnosis was challenging by clinical manifestations. Histopathology and immunohistochemistry should be combined with clinical presentation, history to reach the final diagnose.

Ultrasonographic and pathologic findings of recurred clear cell hydradenoma

Clear cell hidradenoma is a rare benign sweet gland origin tumor in the skin and subcutaneous fat. Almost cases were benign and well removed without recurrence. Therefore, the ultrasonographic (US) study was not performed in most cases. We experienced a case of recurred clear cell hidradenoma and presented here US and pathologic findings of this case. We also discussed clear cell hidradenoma and hidradenocarcinoma. A Case report: A 48-year old woman presented with a solitary nodule on the left upper arm. Two years ago, the patient visited a hospital and got excision without a specific problem. One year later, the nodule recurred. The lesion gradually grew again. A bloody discharge occurred. The patient visited our hospital for further evaluation and removal of the mass. The US showed an about 2-cm sized, ovoid, well circumscribed solid and cystic nodule at the subcutaneous fat layer. Increased vascularity was found on solid portion and the peripheral area. Malignant mass was suspected on the basis of clinical history and US finding. Excisional biopsy was done. On pathology, there was basaloid cell proliferation adjacent to the cyst. Clear cell changes with multiple sweet ducts were also found. These findings are compatible with sweet gland origin tumor. Mitotic activity was up to 2 mitoses/10 high-power fields. Discussion: Clear cell hidradenoma is usually a single, slow-growing, round, mobile, cutaneous nodule ranging between 0.5 cm and 3.0 cm in diameter. Cho, et al, suggested that US findings of benign clear cell hidradenoma were well-defined cystic masses with mural nodules or well-defined solid tumors with hypoechogenicity. Hypervascularity was usually combined. Recently Nazarian et al, described that infiltrative growth pattern, deep extension, necrosis, nuclear pleomorphism, and ≥ 4 mitoses per 10 high-power fields are specific histologic features of clear cell hidradenocarcinoma. Repeated local recurrences and/or systemic metastasis was often documented in the cases of clear cell hidradenocarcinoma. When the US shows a recurred cystic mass with solid mural nodules and increased vascularity, clear cell hidradenoma or hidradenocarcinoma should be included in the differential diagnosis.

Clinicopathological Evaluation of Clear Cell Hidradenoma (Acrospiroma) Within Multiple Tumor Complex in a Dog

Background: Clear cell hidradenoma (acrospiroma) is adnexal tumors that arise from the distal excretory duct of eccrine sweat glands. It is generally defined in humanbeings. It presents solitary structure in firmness nodule. Most frequently are encountered in head, face, and upper extremities in humans. Hidradenomas are called generally by definition benign. Their malignant transformations and metastasis are seen very rarely. In veterinary literature database, the malignant form of tumor has been defined as an unique report in four dogs. They are extremely rare tumors in dogs. It is not documented within multiple tumor complex up to now.Case: In the case, three tumors were detected in a 9-year-old neutered female German shepherd dog. After clinical examination, a complete surgical resection of all masses was performed and masses were sent to Pathology for diagnosis. A mass on the right last rib was a 8x6 cm in diameters with severe ulceration. The mass had a hard texture, immobility and irregular borders. Other masses were localized on the back and left caudo-abdominal mammary lobe. Tumors on the back and the mammary lobe did not invade muscle layer, but the tumor on the last rib aggressively invaded surrounding tissue and were very difficult to remove surgically After macroscopy, all the masses were stained with hematoxylin-eosin (H&E), Mayer’s mucicarmine and Periodic Acid Shiff (PAS) stainings. In the first mass, there were multilobular epithelial islands between prominent fibrous septa from the upper to deep of dermis. The neoplastic cells were generally round or polyhedral in shape. Some of cytoplasms were eosinophilic at different degree. But cytoplasms were generally finely granular and vesicular or clear in appearance. Some cells had possible glycogen deposits. Nucleus was oval to round and had fine reticular chromatin and a distinct nucleolus. The tumor was diagnosed as clear cell hidradenoma. Others were was belonged to hemangioma on the back and malignant mixed tumor in the mammary gland.Discussion: In our case, two cell types having benign characteristics were also noted. Some clear cells contained PAS (+) material showing glycogen deposits. Additionally, there were some fibrous septa separating those cell islands. Thus, it is thought that the histopathology shows parallelism to many reports described in human beigns. Clear cell hidradenoma described in this case is first documentation as benign counterpart on the basis of veterinary literatures even though a previous report including clear cell hidradenocarcinoma in four dogs. And also, it has been reported to be very rarely seen tumor in human beings. However, any hormonies in terms of its predilection site can not be found among the cases with clear cell hidradenoma in human counterparts, because the tumor is encountered at skin of last right rib. This situation has shown us the tumor does not select any predilection site as described in this case. It has been understood on the basis of literatures that this is the first case report of describing benign tumor of ecrine sweat duct in dogs. Also, there has been no any documentation regarding in this multiple tumor complex

Clear cell hidradenocarcinoma of the breast: a very rare breast skin tumor.

Hidradenocarcinoma is an uncommon malignant intradermal tumor of sweat gland origin with a predilection for the face and extremities. It is encountered equally in males and females, usually in the second half of life. These tumors tend to be locally aggressive. In our case, the tumor was located relatively superficially but without any apparent connection to the overlying skin. The typical disease course includes local and sometimes multiple recurrences, and some patients develop regional lymph node and distant metastases. These type of tumors in the parenchyma of the breast are extremely rare. We report a case of hidradenocarcinoma in a 77-year-old woman who presented with a palpable inflammatory nodule in the right breast.

Clear Cell Hidradenocarcinoma of the Ear Helix

Clear cell hidradenocarcinoma is a rare tumor of eccrine sweat gland origin that has a predilection for the head and neck. It has an indolent growth pattern and a higher incidence of regional and distant metastases. Metastasizing adnexal carcinomas are rare; thus, currently there is no uniform treatment guideline. We report a case of an 89-year-old female patient with clear cell hidradenocarcinoma manifesting in the right ear helix that metastasized to the right parotid gland who was treated by wide local excision and radiation therapy.

Clear Cell Hidradenocarcinoma Mimicking Pyogenic Granuloma after Repeated Surgical Excision

Clear cell hidradenocarcinoma (CCH) is a rare tumor arising from the eccrine sweat glands and accounts for 6% of malignant eccrine tumors.1 Typically, CCH presents as a firm dermal nodule with a predilection for the head, face, and extremities,2 but CCH with an exophytic configuration on the chest i

Diagnosis and treatment of clear cell hidradenocarcinoma of the scalp

Clear cell hidradenocarcinoma (CCH) is an exceedingly rare and highly malignant tumor of the eccrine sweat glands. Its treatment is extremely difficult due to the characteristically aggressive clinical course including repeated local recurrence and uncontrollable distal metastasis coming along with a very poor prognosis. Most published case studies recommend a wide surgical excision followed by adjuvant conservative therapy, which is generally considered to be the standard treatment. Two cases of nodular CCH of the scalp either presenting as a singular primary lesion or at an already metastatic stage were analyzed retrospectively. Wide local excision of the tumor couldn't prevent the primary carcinoma from recurring and metastasizing. Both cases received various therapies but the results were unsatisfactory. Although most authors have recommended that early wide surgical excision of the tumor is a feasible therapeutic measurement, our results raise doubts on the efficacy of this treatment strategy. As alternative approaches (i.e. chemotherapy, radiotherapy) are similarly controversial, further studies and a wide exchange of clinical experiences are crucial.

Clear cell hidradenocarcinoma of the eyelid: a case report with a review of the literature

Clear cell hidradenocarcinomas are extremely rare neoplasms, with very few well-documented cases reported in the literature. The most common sites are the head and neck regions. These tumors are histologically malignant but are not always aggressive. They are known for recurrence and may metastasize widely. Treatment is wide local resection. We report on a case of clear cell hidradenocarcinoma occurring over the eyelid together with a review of the literature.

Clear cell hidradenocarcinoma with helpful immunohistochemistry: a case report

International Journal of DermatologyVolume 52, Issue 11 p. 1380-1382 Case report Clear cell hidradenocarcinoma with helpful immunohistochemistry: a case report Uzma Farooq MD, Uzma Farooq MD Kendall Medical Laboratory, Coral Gables, FLSearch for more papers by this authorSonal Choudhary MD, Sonal Choudhary MD Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FLSearch for more papers by this authorJacqueline Russo MD, Jacqueline Russo MD Department of Pathology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FLSearch for more papers by this authorVladimir Vincek MD, PhD, Vladimir Vincek MD, PhD Department of Pathology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FLSearch for more papers by this authorGeorge Elgart MD, George Elgart MD Department of Dermatology, and Cutaneous Surgery, Miller School of Medicine, University of Miami, FL, USASearch for more papers by this author Uzma Farooq MD, Uzma Farooq MD Kendall Medical Laboratory, Coral Gables, FLSearch for more papers by this authorSonal Choudhary MD, Sonal Choudhary MD Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FLSearch for more papers by this authorJacqueline Russo MD, Jacqueline Russo MD Department of Pathology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FLSearch for more papers by this authorVladimir Vincek MD, PhD, Vladimir Vincek MD, PhD Department of Pathology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FLSearch for more papers by this authorGeorge Elgart MD, George Elgart MD Department of Dermatology, and Cutaneous Surgery, Miller School of Medicine, University of Miami, FL, USASearch for more papers by this author First published: 24 September 2012 https://doi.org/10.1111/j.1365-4632.2011.05433.xCitations: 3 Uzma Farooq, mdKendall Medical Laboratory 2500 S. Douglas Road Ste. A Coral Gables FL 33134 USA E-mail: [email protected] Conflicts of interest: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume52, Issue11November 2013Pages 1380-1382 RelatedInformation

Radiotherapy on hidradenocarcinoma

Context:Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment.Case Report:We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity.Conclusion:Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread.

Sunitinib efficacy in the treatment of metastatic skin adnexal carcinomas: report of two patients with hidradenocarcinoma and trichoblastic carcinoma

Adnexal carcinomas are rare and diverse cutaneous tumours. They are locally aggressive and have the potential for distant metastasis. Metastatic adnexal carcinomas are very resistant to conventional chemotherapies. Sunitinib, an oral tyrosine kinase inhibitor, is reportedly effective for the treatment of various solid cancers. Its use in adnexal carcinomas has never been reported. The first patient had metastatic clear cell hidradenocarcinoma and was stabilized over 8 months with sunitinib, before she relapsed. The second patient had a metastatic malignant hair follicle tumour (trichoblastic carcinoma) and achieved a partial remission with sunitinib, and disease stabilized after 10 months. Dynamic contrast-enhanced ultrasound (DCE-US) performed to evaluate tumour vascularization during treatment depicted a dramatic and early decrease in the tumour blood volume. Sunitinib was effective in controlling the disease in our two patients. DCE-US using linear raw data may have an early predictive value for tumour response to sunitinib. Further studies involving larger cohorts of patients are warranted in order to confirm the efficacy of sunitinib in these rare tumours.

Clear Cell Hidradenocarcinoma Developing in Pacemaker Pocket

An octagenerian woman developed clear cell hidradenocarcinoma, a rare neoplasm of eccrine sweat gland origin, 4 years following pacemaker implantation in her right lateral chest. The tumor immunohistochemically mimicked a metastatic lobular breast carcinoma, for example, strongly positive estrogen, weakly positive progesterone, and weakly reactive mammoglobin. A complete surgical excision of the tumor was complemented with ipsilateral dissection of involved adjacent axillary lymph nodes. Recommended irradiation was refused by the patient. Retrospective 3-year mammogram review, 2-year postsurgery follow-up, and complete postmortem evaluation failed to prove a primary breast malignancy or other metastatic lesion elsewhere.

Tricholemmal Carcinoma/Squamous Cell Carcinoma With Tricholemmal Differentiation

Abstract: Tricholemmal carcinoma is a low-grade cutaneous malignancy, which typically arises on the sun-exposed, hair-bearing areas of elderly male patients. Histologically, tricholemmal carcinoma is composed of a lobular proliferation of pale to clear squamoid cells with peripheral palisading. The tumors are typically centered on a pilosebaceous unit and demonstrate follicular and epidermal connections. The presence of cytologic atypia, frequent mitoses, and dermal invasion distinguishes tricholemmal carcinoma from tricholemmomas. Other clear cell tumors that may be considered in the differential diagnosis include clear cell Bowen's disease and squamous cell carcinoma (SCC), clear cell basal cell carcinoma, sebaceous carcinoma, clear cell hidradenoma, hidradenocarcinoma, and metastatic renal cell carcinoma. Tricholemmal carcinoma is typically considered a cutaneous adnexal tumor with differentiation towards the external root sheath epithelium. Although some authors have questioned the validity of this concept and asserted that tricholemmal carcinoma is merely a clear cell SCC, there are distinct histologic differences between tricholemmal carcinoma and clear cell SCC. These include the former's lobular growth pattern, centering on pilosebaceous units, peripheral palisading, and presence of PAS-positive glycogen accumulations, all of which are lacking in cases of clear cell squamous cell carcinomas. However, it may be argued that tricholemmal carcinoma is simply a unique type of clear cell SCC, which either arises from or recapitulates outer root sheath epithelium, explaining its distinct features. In either case, the excellent clinical prognosis of tricholemmal carcinoma argues that this entity should continue to be separated diagnostically from other clear cell tumors of the skin.

Canine Cutaneous Clear Cell Adnexal Carcinoma: Histopathology, Immunohistochemistry, and Biologic Behavior of 26 Cases

Thirty tumors including 27 distinctive cutaneous neoplasms and 3 metastatic tumors from 26 dogs were collected from diagnostic submissions to 3 laboratories. Characteristic histopathologic features included location in the subcutis or dermis (or both); lobular, nodular, and nest-like architecture; and a component of epithelioid cells with clear cytoplasm. Additional features present in most cases included follicular dermal papilla-like structures, low mitotic index, nuclear pleomorphism, necrosis, and mineralization. Cytoplasmic periodic acid Schiff-positivity, which was abolished by pretreatment with diastase, indicated the presence of glycogen in all cases. The oil red O stain did not demonstrate cytoplasmic lipid. Melanin granules, accentuated by the Fontana-Masson method, were observed infrequently. A sparsely cellular mucinous stroma and stromal cartilaginous differentiation were uncommon. By immunohistochemistry, neoplastic cells stained positively for cytokeratin (29 of 29), vimentin (28 of 28), S-100 protein (24 of 29), and melan A (8 of 12); results were negative for smooth muscle actin and calponin in all cases. Clinical follow-up information was obtained on all 26 dogs. One tumor recurred, 1 metastasized to a regional lymph node, and 1 metastasized to regional lymph nodes twice. In another case, possible pulmonary metastasis was noted radiographically. The findings are consistent with a poorly differentiated, low-grade, adnexal carcinoma of the skin. Similar canine cutaneous neoplasms have been reported as "clear-cell hidradenocarcinoma" and "follicular stem cell carcinoma." The authors propose the designation "cutaneous clear cell adnexal carcinoma."

Metastatic Clear-Cell Hidradenocarcinoma of the Vulva

Clear-cell hidradenocarcinoma is a malignant tumor of sweat gland origin. It is most often found on the trunk, head, and extremities. This case report describes a rare occurrence of this tumor on the vulva of a young woman. The discovery of metastatic disease reflects the potentially aggressive nature of this tumor.

Clear Cell Hidradenocarcinoma

A clear cell hidradenocarcinoma occurred in a 15-month-old child. The tumor, present from birth, recurred after two excisions and brought on metastasis to the skin, lymph nodes and lungs. Histologically, there was no evidence of malignancy, not even in the metastasis.