Case Report and Literature Review of Nodular Hiradenoma, a Rare Adnexal Tumor That Mimics Breast Carcinoma, in a 20-Year-Old Woman

Vanya Jaitly, MD; Richard Jahan-Tigh, MD, MS; Tatiana Belousova, MD; Hui Zhu, MD, PhD; Robert Brown, MD; Karan Saluja, MD

Disclosures

Lab Med. 2019;50(3):320-325. 

In This Article

Abstract and Introduction

Abstract

Nodular hidradenoma is an uncommon cutaneous adnexal tumor arising from sweat glands. In the skin, it usually presents as a solitary dermal nodule; excision is curative in most cases. In rare instances, it may present as a breast mass and can mimic breast carcinoma clinically and radiologically, causing diagnostic dilemmas for the treating physician and pathologist. Herein, we discuss a case of nodular hidradenoma in a 20-year-old Hispanic woman as a rapidly growing mass in the breast that mimicked breast carcinoma. We discuss the rare presentation of this uncommon tumor and the differential diagnosis of this entity, as well as the results of our literature review on the topic.

Introduction

Nodular hidradenoma, also known as eccrine acrospiroma or clear cell hidradenoma, is a dermal adnexal tumor that most commonly appears in the head and neck area or the extremities.[1] Apocrine and eccrine gland origin have been suggested: some cases involve decapitation secretion that is classically observed with apocrine origin, whereas other cases exhibit ultrastructural features suggestive of eccrine differentiation.[2] Most of these tumors are benign but may recur after inadequate excision.

Classically nodular hidradenoma consists of solid and cystic areas with varying components of clear, poroid, squamoid and, in rare instances, mucinous cells.[3] Usually, prominent cytologic atypia, mitosis, and necrosis are absent. Nodular hidradenomas occurring in breast tissue are extremely rare and can be misdiagnosed as primary breast carcinoma by physicians and pathologists.

Herein, we describe a case of nodular hidradenoma, occurring in the breast tissue of a 20-year-old Hispanic woman, which clinically mimicked breast cancer. To our knowledge, fewer than 30 cases of this entity are described in the English-language literature and only 12 PubMed-indexed cases have been reported so far.[2–12]

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