Rare Case of a Painless Giant Vascular Eccrine Spiradenoma in an Abnormal Location
Location
LSU Health Sciences Center - New Orleans
Event Website
https://www.medschool.lsuhsc.edu/genetics/2023_medical_student_research_poster_symposium.aspx
Presentation Date
23-10-2023 8:29 AM
Description
Eccrine spiradenomas are rare, benign, painful skin tumors that are thought to arise from eccrine sweat glands, most commonly on the ventral aspect of the head and trunk. It's rare vascular variant, giant vascular eccrine spiradenoma (GVES), should be considered in the differential diagnosis of highly vascular tumors of the skin and soft tissue. We describe a case of GVES on an unusual site in a 63-year-old African-American male with a history of diabetes mellitus and Hepatitis C. He presented with a 3.0 cm, mobile, non-tender, firm, cystic mass, enlarging for 2-3 months on the medial side of the left knee. After full-thickness excision, H&E (A, B) staining revealed two populations of tumor cells; centrally located large pale cells and small dark basaloid cells at the periphery. Immunohistochemistry was positive with CEA (C) to determine the epithelial component of the cells. Basaloid cells stained positive with epithelioid markers, Ck7(D), p63, Cam5.2, and Calponin. The cells were negative for Desmin, CD31, and CD68. The combined histology, immunohistochemistry profile, and hemorrhagic components on gross examination were consistent with GVES classification. Eccrine spiradenomas are typically less than 2 cm; however, this rarely documented variant is much larger. Their high vascularity, bleeding, and ulceration pose a significant challenge in distinguishing GVES from other vascular neoplasms like angiolipoma, angiosarcomas, and glomus tumor-like tumors. Our case occurred at an unusual site as a painless lesion and had an increased number of ectatic vascular spaces that posed a significant diagnostic challenge.
Recommended Citation
Forte, Michael V., "Rare Case of a Painless Giant Vascular Eccrine Spiradenoma in an Abnormal Location" (2023). Medical Student Research Poster Symposium. 38.
https://digitalscholar.lsuhsc.edu/sommrd/2023MSRD/Posters/38
Rare Case of a Painless Giant Vascular Eccrine Spiradenoma in an Abnormal Location
LSU Health Sciences Center - New Orleans
Eccrine spiradenomas are rare, benign, painful skin tumors that are thought to arise from eccrine sweat glands, most commonly on the ventral aspect of the head and trunk. It's rare vascular variant, giant vascular eccrine spiradenoma (GVES), should be considered in the differential diagnosis of highly vascular tumors of the skin and soft tissue. We describe a case of GVES on an unusual site in a 63-year-old African-American male with a history of diabetes mellitus and Hepatitis C. He presented with a 3.0 cm, mobile, non-tender, firm, cystic mass, enlarging for 2-3 months on the medial side of the left knee. After full-thickness excision, H&E (A, B) staining revealed two populations of tumor cells; centrally located large pale cells and small dark basaloid cells at the periphery. Immunohistochemistry was positive with CEA (C) to determine the epithelial component of the cells. Basaloid cells stained positive with epithelioid markers, Ck7(D), p63, Cam5.2, and Calponin. The cells were negative for Desmin, CD31, and CD68. The combined histology, immunohistochemistry profile, and hemorrhagic components on gross examination were consistent with GVES classification. Eccrine spiradenomas are typically less than 2 cm; however, this rarely documented variant is much larger. Their high vascularity, bleeding, and ulceration pose a significant challenge in distinguishing GVES from other vascular neoplasms like angiolipoma, angiosarcomas, and glomus tumor-like tumors. Our case occurred at an unusual site as a painless lesion and had an increased number of ectatic vascular spaces that posed a significant diagnostic challenge.
https://digitalscholar.lsuhsc.edu/sommrd/2023MSRD/Posters/38
Comments
Mentor: Dr. Todd M. Leleux LSUHSC, Department of Pathology