Skin nonmelanocytic tumor
Adnexal tumors
Sweat gland derived (apocrine & eccrine glands)
Eccrine spiradenoma
Authors: Nicole Riddle, M.D., Christopher S. Hale, M.D.
Topic Completed: 1 June 2012
Minor changes: 21 October 2020
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Eccrine spiradenoma [title]
Table of Contents
Definition / general | Essential features | Terminology | Epidemiology | Sites | Etiology | Clinical features | Case reports | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Positive stains | Electron microscopy description | Differential diagnosis | Additional referencesCite this page: Riddle N, Hale C. Eccrine spiradenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticeccrinespiradenoma.html. Accessed October 28th, 2020.
Definition / general
- Benign adnexal tumor with eccrine differentiation, may be derived from the secretory coil
- Extremely painful lesions, anywhere in body
- Rarely transforms to high grade malignancy
Essential features
- Solitary, painful, slowly growing, pink-gray lesion, often > 1cm
- Well circumscribed, round / oval cell nests ("blue balls") in dermis or subcutaneous tissue
- Small basaloid cells on the outside and larger polygonal cells with vesicular nuclei and prominent nucleoli towards the center
Terminology
- Also known as spiradenoma
Epidemiology
- Commonly during reproductive age
Sites
- Trunk > Scalp
- Genital area rare (vulva, clitoris, labia majora)
Etiology
- May be associated with CTNNB1 or CYLD gene mutations (Brooke-Speigler syndrome)
Clinical features
- Painful, slow growing mobile nodule. treated by excision
- Rarely linear, zosteriform or Blaschko line type configuration
- Excellent prognosis (benign lesion), unless malignant transformation
- Malignant transformation: rapid growth, ulceration, discoloration
Case reports
- 41 year old woman with malignant eccrine spiradenoma of vulva (Int J Gynecol Cancer 2006;16:1465)
- 67 year old woman with carcinosarcoma ex eccrine spiradenoma of vulva (Int J Gynecol Pathol 2011;30:301)
- 73 year old with facial lesion (Indian J Dermatol Venereol Leprol 2008;74:541)
Clinical images
Contributed by Nicole Riddle, M.D.
Scalp
Contributed by Dr. Mark R. Wick
Breast skin
Gross description
- Pink–gray or tan nodule, usually solitary
Gross description
- Painful, slow growing solitary nodule, head/neck, adults > children
- Occasional multiple lesions, linear or Blaschkoid distribution
Microscopic (histologic) description
- Well circumscribed, round-oval cell nests ("blue balls") in dermis or subcutaneous
- Closely packed basaloid cells in organoid arrangement – more polygonal in center
- Delicate fibrovascular capsule
- No epidermal connection
- May see ductal structures or squamoid areas
- Lymphocytes common throughout lesion
- Dilated intervening vessels may occur, sometimes so marked as to mimic vascular tumor
- Cystic degeneration may occur
- Malignant transformation: highly atypical cells, infiltrating, with numerous mitoses; sarcomatous features may be seen; often residual benign spiradenoma present
Microscopic (histologic) images
Contributed by Stephanie Liu, D.O., Dr. Amy Lynn and Dr. Asmaa Gaber Abdou
57 year old woman with mass in axillary lymph node
57 year old woman with mass in axillary lymph node
Eccrine spiradenoma
Cytology description
- Small cells with scant cytoplasm, hyperchromatic nuclei, no or minimal atypia, very rare mitoses
Cytology images
Various images
Electron microscopy description
- Epithelial and myoepithelial cells
Differential diagnosis
- Cylindroma: small islands of tumor cells with 'jigsaw puzzle' pattern; thick, eosinophilic, material around cell clusters
- Cutaneous lymphadenoma
- Metastatic carcinoma
- Synovial sarcoma
- Thymoma
Additional references
