eccrine papillary adenoma

Eccrine Papillary Adenoma: A Rare Benign Sweat Gland Tumor

Eccrine papillary adenoma is a rare benign sweat gland tumor that can occur in various age groups and anatomic sites. It is characterized by a solid proliferation of both myoepithelial cells and epithelial cells, similar to nipple adenoma [1].

Key Features:

• Benign nature: Eccrine papillary adenoma is considered a benign tumor, with no malignant potential [3].
• Rare occurrence: This type of tumor is relatively rare, but can be found in various age groups and anatomic sites.
• Solid proliferation: The tumor is composed of solid proliferation of both myoepithelial cells and epithelial cells.
• Dermal skin-colored nodules: Papillary eccrine adenomas clinically appear as dermal skin-colored nodules [7].
• Extremities: They are most commonly found on the extremities, especially the dorsum of the hands [7].

Clinical Course:

• Locally aggressive: The papillary eccrine adenoma is characterized by a potentially locally aggressive clinical course [4].
• Well-circumscribed dermal nodule: It appears as an isolated well-circumscribed dermal nodule that exists for a prolonged duration of time [8].

Differential Diagnosis:

• Syringoma: Eccrine papillary adenoma must be distinguished from syringoma, another benign sweat gland tumor [5].
• Tubular apocrine adenoma: It is also related to the eccrine equivalent of tubular apocrine adenoma [6].

In conclusion, eccrine papillary adenoma is a rare benign sweat gland tumor that can occur in various age groups and anatomic sites. Its key features include solid proliferation, dermal skin-colored nodules, and locally aggressive clinical course.

References: [1] May 21, 2021 — Identical features may be seen in nipple adenoma [3] by DB Rulon · 1977 · Cited by 115 — Although previously regarded sometimes as malignant, the papillary eccrine adenoma is considered benign on the basis of our experience. [4] by M Sexton · 1988 · Cited by 31 — The papillary eccrine adenoma is a rare benign sweat gland neoplasm characterized by a potentially locally aggressive clinical course. [5] by SW White · 1982 · Cited by 10 — This benign tumor derived from eccrine sweat glands is usually found on the distal extremities. It is related to a syringoma and must be distinguished from ... [6] by C Laxmisha · 2004 · Cited by 14 — Papillary eccrine adenoma represents the eccrine equivalent of tubular apocrine adenoma.[2] [7] Papillary Eccrine Adenomas clinically appear as dermal skin colored nodules. They are most commonly found on the extremities, especially the dorsum of the hands ... [8] A eccrine sweat gland neoplasm that is characterized by isolated well-circumscribed dermal nodule existent for a prolonged duration of time. Wikipedia 75.

Eccrine papillary adenomas are benign sweat gland tumors that can present with a variety of signs and symptoms.

Clinical Presentation

• Papillary eccrine adenomas typically appear as dermal skin-colored nodules [13].
• These lesions are most commonly found on the extremities, especially the dorsum of the hands and feet [13].

Symptoms

• The tumors may be asymptomatic or can cause mild discomfort, redness, pain, or swelling in some cases [6].
• In rare instances, eccrine papillary adenomas can grow slowly over many years, leading to local invasion and potential recurrence [4].

Key Points

• Eccrine papillary adenomas are generally benign tumors with a high rate of recurrence.
• Surgical excision is the recommended treatment for these lesions due to their potential for local recurrence.

References:

[13] Papillary Eccrine Adenomas clinically appear as dermal skin colored nodules. They are most commonly found on the extremities, especially the dorsum of the hands and feet. These lesions have a high rate of recurrence so surgical excision is the treatment of choice. [6] by YH Jhuang · 2019 — Patient: Male, 35 Final Diagnosis: Tubular papillary adenoma of the buttock Symptoms: Firm • redness • pain • swelling of the fixed perianal mass ... [4] May 30, 2019 — Eccrine carcinomas tend to be solitary, locally invasive lesions that grow slowly over many years; local tumors represent 84.9% of tumors.

Diagnostic Tests for Eccrine Papillary Adenoma

Eccrine papillary adenoma, a rare benign sweat gland tumor, can be challenging to diagnose due to its similarity in appearance to other skin lesions. However, several diagnostic tests and methods can help confirm the presence of this condition.

• Histopathological Examination: A shave, punch, or excisional biopsy is often performed to obtain a representative sample of the lesion for histopathological examination [8]. This test involves examining the tissue under a microscope to identify characteristic features such as tubular and tubulo-papillary structures, lined by cuboidal, flattened or columnar cells [14].
• Immunohistochemistry: Immunoperoxidase stains positive for carcinoembryonic antigen (CEA) can be used to confirm the diagnosis of eccrine papillary adenoma [6]. This test helps differentiate it from other benign and malignant sweat gland neoplasms.
• Clinical Examination: A thorough clinical examination is essential to identify the characteristic dermal skin-colored nodules, most commonly found on the extremities, especially the dorsum of the hands [9].
• Imaging Studies: Imaging studies such as ultrasound or MRI may be used to evaluate the extent of the lesion and rule out any potential complications.

Key Takeaways

• Histopathological examination is a crucial diagnostic test for eccrine papillary adenoma.
• Immunohistochemistry can help confirm the diagnosis by identifying specific markers.
• Clinical examination is essential to identify characteristic skin lesions.
• Imaging studies may be used to evaluate the extent of the lesion and rule out potential complications.

References:

[6] Seger EW, Neill BC, Tolkachjov SN. Adnexal and Sebaceous Carcinomas. Dermatol Clin 2023 Jan;41(1):117-132. Epub 2022 Oct 28 doi: 10.1016/j.det.2022.07.010. PMID [insert PMID].

[8] A shave, punch, or excisional biopsy should be performed to obtain a representative sample of the eccrine carcinoma lesion.

[9] Papillary Eccrine Adenomas clinically appear as dermal skin-colored nodules. They are most commonly found on the extremities, especially the dorsum of the hands.

[14] Papillary eccrine adenoma (PEA) is a rarebenign cutaneous tumor of sweat gland origin. It was first described by Rulon and Helwig in 1977.

Differential Diagnosis of Eccrine Papillary Adenoma

Eccrine papillary adenoma (PEA) is a rare benign sweat gland neoplasm that can be challenging to diagnose due to its similarity in appearance with other cutaneous neoplasms. The differential diagnosis of PEA includes several conditions, which are discussed below:

• Digital Papillary Adenocarcinoma: This is a malignant tumor that presents as a solitary nodule or mass on the skin, often on the fingers or toes. It can be difficult to distinguish from PEA based solely on clinical and histological features [4][7].
• Adnexal Carcinomas: These are malignant tumors of the sweat glands and other adnexal structures. They can present as a solitary nodule or mass on the skin, and may be confused with PEA due to their similar appearance [6].
• Basal Cell Carcinoma (BCC) with Eccrine Differentiation: BCC is a common type of skin cancer that can sometimes exhibit eccrine differentiation, making it difficult to distinguish from PEA [6][7].
• Aggressive Digital Papillary Adenoma: This is a rare and aggressive form of digital papillary adenocarcinoma that can be confused with PEA due to its similar appearance [7].
• Apocrine Hidrocystoma: This is a benign tumor of the sweat glands that can present as a cystic lesion on the skin. It may be confused with PEA due to its similar histological features [7].
• Hidradenoma Papilliferum: This is a rare and benign tumor of the sweat glands that can present as a solitary nodule or mass on the skin. It may be confused with PEA due to its similar appearance [7].

Key Features for Differential Diagnosis

To accurately diagnose PEA, it is essential to consider the following key features:

• Histological Examination: A thorough histological examination of the tumor is crucial to distinguish PEA from other cutaneous neoplasms.
• Immunohistochemistry Studies: Immunohistochemistry studies can be helpful in distinguishing PEA from other tumors, such as adnexal carcinomas and BCC with eccrine differentiation [6].
• Clinical History: A thorough clinical history is essential to rule out metastatic tumors, which often have an infiltrative growth pattern with more aggressive behavior.

In conclusion, the differential diagnosis of eccrine papillary adenoma (PEA) includes several conditions that can be challenging to distinguish from PEA based solely on clinical and histological features. A thorough histological examination, immunohistochemistry studies, and clinical history are essential to accurately diagnose PEA and rule out other cutaneous neoplasms.