Kundu Ayan, Mondal Tanima R, Ghosh Soma, Dey Soumit, Mahapatra Arijit S
Department of Pathology, M R Bangur Super Speciality Hospital, Kolkata, West Bengal, India.
Department of Pathology, Vivekananda Institute of Medical Science, Kolkata, West Bengal, India.
Indian J Pathol Microbiol. 2021 Apr-Jun;64(2):398-401. doi: 10.4103/IJPM.IJPM_390_20.
Malignant eccrine spiradenoma is an extremely rare neoplasm of adnexal origin. It almost always originates from a preexisting long standing eccrine spiradenoma. We present a case of malignant eccrine spiradenoma arising from benign counterpart and having both carcinomatous and sarcomatous differentiation. Here we present a case of a 46 years old lady who presented with a long standing small nodule on her left leg of 7 years duration with suddenly increase in size. Grossly the mass was partly solid and partly cystic measuring 11.5 cm in maximum dimension with cystic area forming the deeper plane. On microscopy, the superficial dermis showed well demarcated lobules of benign eccrine spiradenoma. Deeper dermis showed tumor cells with features of malignant transformation having both carcinomatous and sarcomatous component. After wide local excision patient is now doing well. The diagnosis of malignant eccrine spiradenoma requires a thorough histopathological examination of the lesion and requires finding a focus of benign spiradenoma within or adjacent to malignant tumour. Wide local excision and close follow-up for early detection of recurrence and metastasis is the mostly recommended management modality.
恶性小汗腺螺旋腺瘤是一种极其罕见的附属器源性肿瘤。它几乎总是起源于先前存在的长期小汗腺螺旋腺瘤。我们报告一例起源于良性对应物且具有癌性和肉瘤样分化的恶性小汗腺螺旋腺瘤病例。在此，我们报告一例46岁女性患者，她左腿有一个持续7年的小结节，近期突然增大。大体上，肿块部分为实性，部分为囊性，最大直径为11.5 cm，囊性区域位于更深层面。显微镜下，浅表真皮显示界限清楚的良性小汗腺螺旋腺瘤小叶。更深层的真皮显示具有恶性转化特征的肿瘤细胞，同时具有癌性和肉瘤样成分。广泛局部切除术后，患者目前情况良好。恶性小汗腺螺旋腺瘤的诊断需要对病变进行全面的组织病理学检查，并且需要在恶性肿瘤内部或邻近部位找到良性螺旋腺瘤的病灶。广泛局部切除并密切随访以早期发现复发和转移是最推荐的治疗方式。
