Skin nonmelanocytic tumor
Adnexal tumors
Sweat gland derived (apocrine & eccrine glands)
Apocrine tubular adenoma
Last author update: 1 May 2015
Last staff update: 18 April 2023 (update in progress)
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PubMed Search: Apocrine tubular adenoma
Table of Contents
Definition / general | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Electron microscopy description | Differential diagnosisCite this page: Sriharan A. Apocrine tubular adenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticapocrinetubularadenoma.html. Accessed June 6th, 2023.
Definition / general
- Benign dermal adnexal neoplasm of apocrine derivation
- Most common location is scalp, typically in women (M:F ratio is 1:2)
- Also called apocrine adenoma, tubular adenoma, tubulopapillary hidradenoma, papillary tubular adenoma
- Associated with organoid nevus, nevus sebaceus of Jadassohn and syringocystadenoma papilliferum (SCAP)
- Rarely occurs in nose, eyelid, leg, trunk, axilla, chest, external auditory meatus, cheek, vulva
- Clinically asymptomatic, sometimes smooth, sometimes irregular, well-defined nodule
- Usually < 2 cm but reported up to 7 cm
Case reports
- 12 year old girl with tubular apocrine adenoma and syringocystadenoma papilliferum of back (Ann Dermatol 2011;23:S151)
- 25 year old man with lipomatous apocrine adenoma with syringocystadenoma papilliferum (Head Neck Oncol 2011;3:36)
- 48 and 60 year old women with tubular adenoma of skin with follicular and sebaceous differentiation (Am J Dermatopathol 2006;28:142)
- 61 year old woman with tubular apocrine adenoma of nose (Eur J Dermatol 2011;21:132)
- 63 year old man with tubular apocrine adenoma mimicking basal cell carcinoma (J Am Acad Dermatol 2014;71:e45)
- Tubular apocrine adenoma on trunk with follicular differentiation (J Dermatol 2012;39:653)
Treatment
- Complete excision is curative
- Malignant transformation is rare
Clinical images
Images hosted on other servers:
Mimics basal cell carcinoma
Gross description
- Firm, slow growing, dermal or cutaneous skin colored nodule
Microscopic (histologic) description
- Well circumscribed dermal neoplasm that may extend into subcutis
- Lobular pattern of dermal and subcutaneous tubular apocrine structures often encased by a fibrous, sometimes hyalinized stroma
- Lobules have dilated, variably sized tubules lined by two layers of epithelial cells
- Pseudopapillae are common, but true papillae are more often associated with SCAP
- Decapitation secretion by apical layer
- Cuboidal to columnar cells with eosinophilic cytoplasm and round bland nuclei
- Often hyaline and clear cell change
- May show cyst formation with papillae or pseudopapillae protruding into the lumen
- Variable overlyng epidermal hyperplasia
- Rare connection with overlying epidermis
Microscopic (histologic) images
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Intradermal nodule
Positive stains
Negative stains
Electron microscopy description
- Tall columnar cells on basal lamina forming acini
- Cells lining tubules have luminal villi and apical pinching
- Conspicuous mitochondria, prominent golgi
- Lipid rich cytoplasmic secretory vacuoles
- Decapitation secretion (J Am Acad Dermatol 1984;11:639)
Differential diagnosis
- Apocrine cystadenoma: more dilated, cystic spaces rather than tubules
- Hidradenoma papilliferum: often has complex arborizing papillae, with more closely arranged tumor cells and glands
- Limited to female genital region
- Papillary apocrine carcinoma: more cytologic atypia, irregular nuclear contours and a higher mitotic rate
- Papillary eccrine adenoma: classically has features of eccrine rather than apocrine derivation; lacks decapitation secretion; different clinical presentation and distribution
- Syringocystadenoma papilliferum:
- Usually connects to epidermis
- Fibrovascular cores within papillary structures
- Plasma cells within stroma
- Tubular apocrine adenoma may be a variant
