Lim S C, Lee M J, Lee M S, Kee K H, Suh C H
Department of Pathology, Chosun University College of Medicine, Kwangju, South Korea.
Pathol Int. 1998 Oct;48(10):818-23. doi: 10.1111/j.1440-1827.1998.tb03843.x.
A giant hidradenocarcinoma presented by a 75-year-old female is reported. The patient had a malignant transformation within a nodular hidradenoma involving the right postauricular area, which was treated by mass removal and a right radical neck dissection with a free-flap covering. Malignant hidradenocarcinoma is the least common adnexal tumor of uncertain origin. They are usually malignant from their inception, but some develop from a benign counterpart. To the authors' knowledge, only three cases have been reported previously. Two histologically distinct components were seen in this tumor: (i) typical nodular hidradenoma, which constituted a small part of the tumor; and (ii) carcinoma with areas of transition. The secretory cells of hidradenocarcinoma showed decapitation secretion on light and electron microscopic observations, which is evidence of apocrine differentiation. Histologically, this case was concluded as a hidradenocarcinoma arising from a long-standing nodular hidradenoma. A literature review is presented and the histological, immunohistochemical and ultrastructural features are described.
报告了一例由一名75岁女性表现出的巨大汗腺癌。患者在涉及右耳后区域的结节性汗腺腺瘤内发生了恶性转化，通过肿块切除和带游离皮瓣覆盖的右根治性颈清扫术进行治疗。恶性汗腺癌是起源不明的最不常见的附属器肿瘤。它们通常从一开始就是恶性的，但有些是由良性对应物发展而来。据作者所知，此前仅报道过三例。在该肿瘤中可见两个组织学上不同的成分：（i）典型的结节性汗腺腺瘤，占肿瘤的一小部分；（ii）具有过渡区域的癌。汗腺癌的分泌细胞在光镜和电镜观察下显示断头分泌，这是顶泌汗腺分化的证据。组织学上，该病例被诊断为由长期存在的结节性汗腺腺瘤引起的汗腺癌。本文进行了文献综述并描述了组织学、免疫组化和超微结构特征。
