Skin nonmelanocytic tumor
Adnexal tumors
Sweat gland derived (apocrine & eccrine glands)
Hidradenoma


Minor changes: 3 May 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Eccrine acrospiroma [title]

Jasmine Saleh, M.D., M.P.H.
Jodi Speiser, M.D.
Page views in 2020: 28,973
Page views in 2021 to date: 16,543
Cite this page: Saleh J, Speiser J. Hidradenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticeccrineacrospiroma.html. Accessed June 23rd, 2021.
Definition / general
Essential features
  • Presents as a slow growing, nodular, solid or cystic cutaneous mass usually measuring up to 3 cm in diameter (Dermatology 2016;232:78)
  • Characterized by variably sized nests and nodules of epithelial cells within the upper or mid dermis, typically with no overlying connection to the epidermis (J Clin Pathol 2007;60:145)
  • Wide local excision is the treatment of choice (J Neurosci Rural Pract 2014;5:423)
Terminology
  • Also known as nodular hidradenoma, eccrine acrospiroma, clear cell hidradenoma, eccrine sweat gland adenoma, solid cystic hidradenoma and clear cell myoepithelioma
Epidemiology
Sites
Clinical features
  • Presents as a slow growing, nodular, solid or cystic cutaneous mass usually measuring up to 3 cm in diameter (Dermatology 2016;232:78)
  • Overlying skin can be flesh colored, erythematous or blue and may exhibit superficial ulceration or serous discharge (Indian Dermatol Online J 2016;7:410)
Case reports
Treatment
Gross description
Microscopic (histologic) description
Microscopic (histologic) images

Contributed by Jasmine Saleh, M.D., M.P.H. and Jodi Speiser, M.D.

Intradermal nodule

Polyhedral basophilic cells

Clear cells

CK8/18

CEA

Positive stains
Negative stains
Molecular / cytogenetics description
Sample pathology report
  • Skin, neck, excision:
    • Hidradenoma, extending to the deep margin
Differential diagnosis
  • Metastatic renal cell carcinoma (i.e. thyroid, lung, renal)
  • Basal cell carcinoma with eccrine differentiation:
    • Peripheral palisading and no cystic areas
  • Hidradenocarcinoma:
    • Greater cytologic atypia, mitoses and infiltrative
  • Squamous cell carcinoma:
    • Epidermal connection, keratin pearls and infiltrative
    • Absence of secretory differentiation
  • Trichilemmoma:
    • Broad connection with the epidermis
    • CD34, thickened hyalinized basement membrane and peripheral cell palisading
  • Poroma:
    • Epidermal connection and broad, anastomosing cords
    • Poroid cells, cuticle lined ducts and recurrent YAP1-MAML2 and YAP1-NUTM1 fusions identified in a subset
    • Preliminary data suggest that poroid hidradenoma may be more closely related to poroma than nodular hidradenoma (J Clin Invest 2019;129:3827)
  • Cylindroma:
    • Jigsaw puzzle pattern
    • Hyaline globules and thickened basement membranes
Board review style question #1

    Which of the following is true about hidradenoma?

  1. Frequently has an epidermal connection
  2. Presents as a fast growing mass
  3. Typically encapsulated
  4. Typically located on the head, neck and extremities
Board review style answer #1
D. Typically located on the head, neck and extremities

Reference: Hidradenoma

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