Skin Adnexal Tumors Research Articles

Novel meso-substituted porphyrin derivatives and its potential use in photodynamic therapy of cancer

BackgroundPhotodynamic therapy (PDT) is an anticancer treatment that utilizes the interaction of light and a photosensitiser (PS), promoting tumour cell death mediated by generation of reactive oxygen species. In this study, we evaluated the in vitro photoactivity of four meso-substituted porphyrins and a porphyrin coupled to a fullerene.MethodsThe cell line employed was the LM3 mammary adenocarcinoma, and the PS with the best photokilling activity was administered to mice bearing the LM3 subcutaneously implanted adenocarcinoma. The TEMCP4+ porphyrin and its analogue TEMCC4+ chlorine contain four identical carbazoyl substituents at the meso positions of the tetrapyrrolic macrocycle and have A4 symmetry. The TAPP derivative also has A4 symmetry, and it is substituted at the meso positions by aminopropoxy groups. The DAPP molecule has ABAB symmetry with aminopropoxy and the trifluoromethyl substituents in trans positions. The TCP-C604+ dyad is formed by a porphyrin unit covalently attached to the fullerene C60.ResultsThe PSs are taken up by the cells with the following efficiency: TAPP> TEMCP4+ = TEMCC4+ > DAPP >TCP-C604+, and the amount of intracellular PS correlates fairly with the photodamage degree, but also the quantum yields of singlet oxygen influence the PDT outcome. TAPP, DAPP, TEMCC4+ and TEMCP4+ exhibit high photoactivity against LM3 mammary carcinoma cells, being TAPP the most active. After topical application of TAPP on the skin of mice bearing LM3 tumours, the molecule is localized mainly in the stratum corneum, and at a lower extent in hair follicles and sebaceous glands. Systemic administration of TAPP produces a tumour: normal skin ratio of 31.4, and high accumulation in intestine and lung.ConclusionThe results suggest a potential use of topical TAPP for the treatment of actinic keratosis and skin adnexal neoplasms. In addition, selectivity for tumour tissue after systemic administration highlights the selectivity of and potentiality of TAPP as a new PS.

Sebaceous neoplasms: prevalence of HPV infection and relation to immunohistochemical surrogate markers.

Sebaceous neoplasms (SNs) and carcinomas (SCs) represent rare skin adnexal tumours. To establish the prevalence of HPV in SNs, assess the relationship between HPV, p16 and p53 expression, and further elucidate the carcinogenetic course of SCs. A total of 113 resected SNs (five sebaceous adenomas, 10 sebaceomas and 98 SCs) from the Near-East were reviewed. Clinical information (age, gender, size and anatomical location), microscopic variables, and expression of several immunohistochemical markers (EMA, CK5/6, p63, p40, AR, p16 and p53) were documented. Cases were evaluated by fluorescently labelled PCR for HPV detection, followed by DNA microarray hybridization for subtype detection. HPV infection was detected in 9.4% of SNs: 28.6% sebaceous adenomas (HPV-16 and HPV-66), 9.1% sebaceomas (HPV-18) and 8.1% SCs. High-risk HPV types (HPV-16, -18, -52 and -66) constituted 90.9% of HPV infections. Histologically, HPV-positive SCs showed significantly milder cytologic atypia and patchy cellular necrosis. p16 was expressed in SNs irrespective of HPV status (20.0%, 33.3% and 65.5% of HPV-negative sebaceous adenomas, sebaceomas, and SCs, respectively), and p53 was abnormally expressed in 95.5% of HPV-negative SCs and all HPV-positive SCs. HPV infection is significantly present in benign and malignant SNs. HPV-positive SCs exhibit less cytologic atypia and necrosis than HPV-negative cases. p16 is not a surrogate marker of HPV infection in the SN setting. Further elucidation of various carcinogenic mechanisms in SCs will allow clinicians to single out the various populations at risk, optimize possible preventive strategies and develop targeted therapies.

HISTOPATHOLOGICAL SPECTRUM OF SKIN ADNEXAL NEOPLASMS AT MAYO HOSPITAL, LAHORE

Objective: To find out the frequency of benign and malignant skin adnexal neoplasms.
 Study design: Descriptive study.
 Materials and methods: It is a descriptive study in which we studied all cases of skin adnexal tumors that are registered in Mayo hospital over the period of six months. Tumors were evaluated according to the type and site , age and gender of the patient. The tumors are classified by WHO classification. Data collected was analyzed using SPSS Version 21 for statistical analysis.
 Results: 45 skin adnexal tumors were studied in which, 40 (88.9%) were benign and 5 (11.1%) were malignant.
 Conclusion: Skin adnexal tumors are comparatively uncommon lesions. Benign neoplasms are more frequent than malignant.

Poroid adnexal skin tumors with YAP1 fusions exhibit similar histopathologic features: A series of six YAP1-rearranged adnexal skin tumors.

Adnexal skin tumors are diagnostically challenging with few known molecular signatures. Recently, however, YAP1-MAML2 and YAP1-NUTM1 fusions were identified in poroid adnexal skin tumors. Herein, we subjected eight poroid adnexal skin tumors (three poromas and five porocarcinomas) to fusion gene analysis by whole transcriptome sequencing and next-generation DNA sequencing analysis. YAP1 fusions were identified in six cases. YAP1-NUTM1 fusions were identified in two poromas and three porocarcinomas. A single case of porocarcinoma harbored a YAP1-MAML2 fusion. Two cases were negative for gene fusion. All cases that harbored YAP1-NUTM1 fusions showed nuclear protein in testis (NUT) expression by immunohistochemistry, with NUT being negative in the YAP1-MAML2-positive case. In this case series, we provide a detailed histopathologic description of six YAP1-fused poroid skin tumors, which we show harbor reproducible histopathologic features, to include broad, bulbous tumor tongues with admixtures of basaloid, poroid cells punctuated by squamatized cuticles and ductules, with uniform tumor nuclei featuring frequent grooves and pseudonuclear inclusions. Awareness of the characteristic histopathologic features of YAP1-fused poroid adnexal skin tumor is a step toward a more reproducible classification of adnexal skin tumors as well as a step toward targeted therapy for metastatic and/or unresectable examples of this poroid group of neoplasms.

Malignant skin adnexal tumor with eccrine differentiation– A rare case report with review of literature

Malignant skin adnexal tumor with eccrine differentiation– A rare case report with review of literature

Malignant skin adnexal tumor with eccrine differentiation– A rare case report with review of literature

Malignant skin adnexal tumor with eccrine differentiation– A rare case report with review of literature

Trichoadenoma of vulva: A rare case with rare site of presentation

Trichoadenoma is a rare benign adnexal tumor of skin with differentiation towards hair structure. It was first described by Niklowski in 1958 and so is also known as trichoadenoma of Nikolowski. It shares its features with trichoepithelioma and trichofolliculoma, which are the other common benign adnexal tumors with differentiation towards hair structure. Vulva being an unusual site for occurrence of trichoadenoma, there are very few cases reported in the literature at this site. Here we report a case of trichoadenoma of vulva. Keywords: adnexal tumor hair follicle differentiation trichoadenoma.

Challenges in diagnosis and management of a spiradenocarcinoma: a comprehensive literature review.

Spiradenocarcinoma is a rare skin adnexal neoplasm that may behave aggressively. It is often associated with a benign slow-growing spiradenoma that has undergone malignant transformation. Given the paucity of cases in the literature, there is a lack of consensus on treatment. The terms 'malignant spiradenoma' or 'spiradenocarcinoma' were systematically used to search the PubMed, MEDLINE and Google Scholar databases. A total of 182 cases of spiradenocarcinoma were identified as eligible for this comprehensive literature review. Spiradenocarcinoma was commoner in older age and Caucasian race. In most cases, surgical excision for local disease is the mainstay of treatment. Lymph node dissection is usually reserved for those with suspected or confirmed lymph node metastases. High rates of local recurrence (20.8%), metastasis (37.4%) and mortality (19.1%) were identified, prompting some authors to suggest regular follow up including chest X-rays and liver function tests. Patients with spiradenocarcinoma may benefit from a magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography/computed tomography to establish the extent of disease. We recommend wide local excision as the treatment of choice to achieve surgical margins of ≥1cm, with node resection to be determined on a case-to-case basis. Regular follow up is important given the high rate of local recurrence, metastasis and mortality. This should include an examination of the regional lymph nodes. Further research is required to refine an evidence-based approach to spiradenocarcinoma.

Histopathological patterns of skin adnexal tumours in Ibadan, South-West Nigeria

Background: Skin adnexal tumours (SATs) are tumours that differentiate towards one or more of the adnexal structures of the skin. The aim of this study was to determine the incidence of SATs in Ibadan and to correlate them with age, sex and anatomic location. Methods: This is a 10-year retrospective study of all SATs in the Department of Pathology, University College Hospital, Ibadan. The clinicopathological data were obtained from the department's records for the given period. Haematoxylin and eosin-stained sections obtained from formalin-fixed paraffin-embedded tissue blocks were examined to confirm the diagnosis and special stains such as periodic acid Schiff staining done where necessary. Cases of SATs were further classified into benign and malignant tumours. Results: Twenty-seven cases of SATs were reviewed over the study period. Tumours from the sweat glands formed the largest group (55.6%) with trichoepithelioma being the most common subtype, followed by tumours with follicular differentiation (40.7%) and sebaceous tumours (3.7%). There was a slight female predominance with a male-to-female ratio 1:1.07. The highest number of tumours was seen in the fourth decade of life (23%). Benign tumours made up the majority of cases (85.2%). The most common location was the head and neck with 40.8% of cases. Conclusion: SATs are not uncommon among Nigerian patients. These tumours are mostly benign and are present commonly in the head and neck location.

Recurrent Cutaneous Adenoid Cystic Carcinoma of Forehead

Adenoid Cystic Carcinoma (ACC) is a malignant tumour more commonly seen in salivary glands and rarely arises from the skin as adnexal tumour. Cutaneous ACC is a rare malignant adnexal tumour of eccrine origin. It has an indolent course and rarely metastasizes. Hereby, authors report a case of 48-year-old male with complaints of swelling on right forehead present for the past four years. Clinical diagnosis of infected sebaceous cyst was made and excised with simple excision. The swelling reappeared within 15 days of first surgery. The cytological examination of the swelling revealed abundant cellularity with predominantly cohesive clusters of monomorphic population of cells centered around eosinophilic hyaline globules suggestive of ACC. Retrieval of previous biopsy report revealed diagnosis of ACC reaching the margins of excision, the report of which was neither collected by either operating surgeon nor by the patient. Histopathological examination revealed classical cribriform pattern of arrangement of tumour cells with perineural infiltration by tumour cells. Immunohistochemistry further confirmed the diagnosis. The present case report brings out the importance of clearance of surgical margins in malignant tumours, including skin adnexal tumours. It also highlights the importance of histopathological examination of benign looking skin adnexal tumours.

Glioma-Associated Oncogene-1 Expression in Basal Cell Carcinoma and Its Histologic Mimics.

Basal cell carcinoma (BCC) is the most common skin cancer, and it has numerous histologic mimics with variable prognoses and treatments. Although some immunohistochemical stains can be used for the differential diagnosis of BCC, variability and overlap in results can complicate their interpretation. Immunohistochemical staining for glioma-associated oncogene-1 (Gli-1) was performed on 26 nodular BCCs, 22 infiltrative BCCs, 9 basaloid squamous cell carcinomas, 12 desmoplastic trichoepitheliomas, 19 Merkel cell carcinomas, 11 sebaceous carcinomas, 10 cylindromas, 14 spiradenomas, 12 adenoid cystic carcinomas (AdCC), and 1 solitary trichoepithelioma. Strength of staining was scored as 0, 1+, 2+, or 3+, and distribution of staining was categorized as diffuse, multifocal, or focal. Strong, diffuse Gli-1 expression was seen in all tumors with basal epidermal-type differentiation, including BCC, trichoepithelioma, and basaloid squamous cell carcinoma. All examples of Merkel cell carcinoma were negative for cytoplasmic expression. Seven out of 11 sebaceous carcinomas were negative for Gli-1, and the remaining 4 showed 1+ expression. Cylindroma, spiradenoma, and AdCC, each an adnexal skin tumor, showed the most variable staining, but with cylindroma and spiradenoma demonstrating comparable labeling patterns. Overall, although Gli-1 may not distinguish between basal epidermal-type tumors, it may have a role in separating that group from lesions with adnexal differentiation, particularly sebaceous carcinoma, but also cylindroma, spiradenoma, and AdCC. Any cytoplasmic staining seems to exclude the diagnosis of Merkel cell carcinoma.

Skin Adnexal Tumors: A study of 26 cases

Background: Skin adnexal tumours are a category of rare tumours. They usually present as painless nodules and papules. The diagnosis of these tumours poses a challenge, because there is usually a discrepancy in clinical and histopathological diagnosis.
 Aims: To study the skin biopsies received in our department and compare their clinical and histopathological diagnosis.
 Material and methods: Prospective study of skin biopsies received in our department over a period of 1 year. The biopsies were processed and stained with haematoxylin and eosin and studied under the light microscope.
 Results: Out of the 26 cases studied, 25 were found to be benign tumours with a single case of keratoacanthoma. The most common tumour encountered was pilomatricoma and the least common was syringoma. Only four cases showed clinical correlation with histopathological diagnosis.
 Conclusion: It can be therefore concluded that skin adnexal tumours are rare tumours which need histopathological examination for their accurate diagnosis.

Cytological Evaluation of Palpebral Lesions: An Insight into its Limitations Aided with Histopathological Corroboration.

Context:Eyelids by virtue of its unique histomorphology give rise to multitudes of different pathological conditions. Appropriate preoperative cytological diagnoses of these cases are necessary to determine their optimal therapy.Aims:The aims of this study were to evaluate the utility of various cytological techniques in diagnosing the definite pathology for palpebral lesions and thereby to highlight the drawbacks associated with cytology in this context.Materials and Methods:Fine-needle cytology with or without applying the aspiration was the preferable method. Ulcerated lesions were sampled through scrapings.Results:Totally 62 cases were examined. Cytologically, 22 lesions were diagnosed as nonneoplastic, 38 lesions were neoplastic, and nondiagnostic material was obtained twice. Malignant tumors predominated among the neoplastic cases. Basal cell carcinoma (BCC) was the most common malignancy observed. On histopathological corroboration, benign skin adnexal tumor was found to be the most frequently misinterpreted entity. Two (out of four cases) of those tumors were confirmed as melanocytic nevus and BCC. A single case of squamous cell carcinoma was also cytodiagnostically erred into sebaceous carcinoma.Conclusions:Cytologically palpebral pathologies, including the neoplastic ones, are at times vulnerable to misinterpretation. To avert such dilemma, it is better to readily excise any recurrent lesion, basaloid neoplasm, or any necrohemorrhagic lesion presumptive of overshadowing the neoplastic pathology underneath.

Clinico-pathological study of skin adnexal tumours in a tertiary care hospital

Background: Skin adnexal tumours are heterogenous group of uncommon tumours having distinct histological features. They have varied clinical presentation and morphological differentiation towards one or more types of adnexal structures found in normal skin. The aim of this study was to study the different histomorphological patterns of appendageal tumours and correlate them with clinical presentations. Materials and Methods: This was a retrospective study of three year duration of all cases clinically diagnosed to be appendageal tumours and confirmed by histopathology in our department. The tumours were classified according to their differentiation after a detailed histopathological examination in haematoxylin and eosin sections. Results: The total number of cases in the study were 43,in which 28 were males and 15 females. Most of the tumours (97.7 %)were benign and there was only one case sebaceous carcinoma. The majority of the tumours had an eccrine differentiation (30.9%), nodular hidradenoma among them being the most common lesion (20.9%). Trichilemmal cyst (30.2%) constituted the maximum cases of pilar origin. Conclusion: Skin adnexal tumours are relatively rare with benign ones being more common than the malignant tumours. Proper clinical correlation and histopathological study helps in reaching a correct diagnosis. Keywords: Appendageal, Skin tumour, Eccrine, Nodular hidradenoma, Sebaceous carcinoma.

Challenges in Diagnosis and Management of Spiradenocarcinoma: A Case Report

Spiradenocarcinoma is a rare skin adnexal neoplasm that may behave aggressively. It is often associated with a benign slow-growing spiradenoma that has undergone malignant transformation, characterised by rapid growth and tenderness. They often present as solitary skin nodules and are classified as low-grade or high-grade tumors. We report a case of a high-grade spiradenocarcinoma in association with a benign spiradenoma, measuring 3.2 x 3 x 2.8 cm, situated on the chest wall of a 63-year-old male. The lesion had been enlarging over 20 years but recently became painful, prompting treatment. Preoperative ultrasound revealed a complex vascular lesion suggestive of a dermoid cyst. Excision of the tumor under general anaesthesia was performed. Histopathology confirmed a high-grade spiradenocarcinoma cleared of margins by 1 mm. Wide local excision of the scar, with a 1 cm margin, confirmed no further malignancy. An FDG PET-CT showed no evidence of distant metastases. The patient recovered well and has had no evidence of tumor recurrence at the 3-month follow-up. Given the rarity of this neoplasm and the paucity of cases in the literature, there is a lack of consensus on treatment. In most cases, surgical excision with adequate margins is the mainstay of treatment, with lymph node dissection reserved for those with suspected or confirmed lymph node metastases.

CHONDROID SYRINGOMA OF MEDIAL CANTHUS – A RARE CASE REPORT

Chondroid syringoma of the skin is a rare, benign skin adnexal tumor, usually exhibited as a slowly growing intradermal or subcutaneous nodule, typically located in the head-and-neck region. Chondroid syringoma usually appears on the face; medial canthus being a rare site of predilection. The diagnosis is usually made retrospectively based on histological features of the surgically excised mass which is usually asymptomatic. We present a rare case of a 35-year-old man who presented with a painless, subcutaneous nodule in the medial canthus of the right eye. The diagnosis of chondroid syringoma was rendered. To the best of our knowledge, only one case of chondroid syringoma of the medial canthus has been documented in the literature. Histopathological examination is mandatory for arriving at the diagnosis. It should be considered in the differential diagnosis of all the slowly growing nodular lesions in the face.

Varied presentation of skin adnexal tumors - A case series with review of literature

Skin adnexal tumours are a heterogeneous group of uncommon and rare tumours usually misdiagnosed clinically due to different types and similar presentation. They include a diverse group of benign and malignant neoplasms. They may present as single or multiple lesions and can be sporadic or familial in inheritance. They might be a superficial manifestation of an internal malignancy. Benign lesions are more common but malignant tumours are rare and locally aggressive, with potential nodal and distant metastasis with a poor clinical outcome. Histopathology is the basis of critical diagnosis, which has therapeutic and prognostic implications. Here we report a case series of skin adnexal tumours with aggressive behaviour on histopathology which appeared benign clinically. This case series emphasises the need for early detection and proper follow up of skin adnexal tumours to reduce the morbidity and mortality.

Skin adnexal tumors: a 5 years single institutional experience

<p class="abstract"><strong>Background:</strong> Skin tumors comprise of innumerable benign and malignant lesions. They vary in behaviour and malignant potential. Apart from more common melanomatous and squamous cell carcinomas, there exist unexplored arena of adnexal tumors that are rare and most often pose a dilemma for treating doctor. Their demography and presentation are yet to be standardized globally.</p><p class="abstract"><strong>Methods:</strong> This is a cross-sectional descriptive study undertaken in department of surgical oncology, government Royapettah hospital, Chennai from January 2013 to 2019, primarily focused to analyze the various cutaneous adnexal tumors with regard to age, sex, site, size, behavior, origin of these tumors and to correlate with the clinical presentation. Descriptive characteristics like frequencies were computed for categorical variables like gender, histologic diagnosis, primary site of disease, and type of surgical treatment, while numeric variables were summarized using mean with standard deviation, median and range. <strong></strong></p><p class="abstract"><strong>Results:</strong> Thirteen cutaneous adnexal lesions were reported in the past 5 years at our institute. Out of the 13 cases two were benign and eleven were of malignant skin adnexal tumors. Sweat gland tumors were the most common tumors encountered and were found to be more common in males below age of 60, trunk being common site of occurrence.</p><p class="abstract"><strong>Conclusions:</strong> One should have high index of suspicion, aided by proper histopathology followed by aggressive treatment is necessary for proper control. Most of them need adjuvant treatment. No standardized treatment poses some problem, that needs to be addressed with proper documentation.</p>

Skin Adnexal Tumors: A Histopathological analysis of 30 Cases at a Tertiary Care Centre

Skin Adnexal Tumors: A Histopathological analysis of 30 Cases at a Tertiary Care Centre

Spectrum of various skin nodule mimicking cutaneous adnexal tumour

Introduction: Cutaneous adnexal tumors are the group of uncommon tumour usually misdiagnosed clinically with various soft tissue tumour. Therefore, histopathology is the gold standard to diagnose their histogenesis. The aim of the present study is to find out the occurrence of skin adnexal tumors according to age, sex and site distribution along with histopathological diagnosis. Materials and Methods: This retrospective study was conducted in Department of Pathology of Pacific Institute of Medical sciences, Udaipur from September 2016 to August 2019. The formalin fixed paraffin embedded tissue section was stained with hematoxylin and eosin stain for microscopical analysis. Results: A total number of 41 adnexal tumors out of which 22 males and 19 females were studied out of which 36 cases were diagnosed as benign and 5 cases were reported as malignant. The most common cutaneous adnexal tumors diagnosed as sweat gland origin followed by hair follicle, sebaceous gland and pagets disease of nipple. Majority of the cutaneous adnexal tumors reported in head and neck site in a fourth to sixth decades of life. Conclusion: Architectural features help us to diagnose different types of cutaneous adnexal tumors.