Hidradenona apócrino: Diagnóstico ecográfico

Resumo

O hidradenoma nodular é um raro tumor benigno derivado de glândulas sudoríparas. Histologicamente, estes tumores podem ser classificados em dois subtipos: écrinos e apócrinos. Na maioria dos casos, o diagnóstico é feito após a excisão cirúrgica e embora sigam geralmente um curso benigno, a sua transformação maligna foi já documentada. Apresentamos um caso de hidradenoma apócrino com envolvimento dos vasos linfáticos. Descrevemos os achados ecográficos do hidradenoma de células claras do braço num homem de 82 anos. A lesão envolveu a derme e a hipoderme e apresentou-se como uma estrutura ovóide bem definida com aparência sólido-quística com bordos hipoecoicos e uma estrutura interna contendo um nódulo sólido hipoecoico com vascularização marcada e uma estrutura quística com conteúdo líquido lacunar anecoico. Em comparação com outras lesões cutâneas comuns, os hidradenomas nodulares apócrinos apresentam características ecográficas típicas, o que pode suportar o diagnóstico ecográfico antecipado e mais preciso, evitando erros diagnósticos clínicos e dermatoscópicos.

Biografia do Autor

Angela Serafim, University of Algarve Faculty of Sciences & Technology Campus de Gambelas 8005-139 Faro, PORTUGAL

Licenciatura em biologia.

PhD em Toxicologia ambiental

Pos-doc em saúde humana

Mestrado em Medicina

Referências

Storm CA, Seykora JT. Cutaneous Adnexal Neoplasms. Am J Clin Pathol 2002; 118(1):33-49

Klein W, Chan E, Seykora JT. Tumors of the epidermal appendages. In: Elder DE (Editor-inChief). Lever’s histopathology of the skin. 9th edn. Philadelphia, PA: Lippincott Williams & Wilikins, 2005; 867-926

Weedon D. Tumors of cutaneous appendages. In: Weedon D. Skin pathology. 2nd adn. Edinburgh: Churchill Livingstone, 2002:859–916

Obaidat NA, Awamleh AA, Ghazarian DM. Adenocarcinoma in situ arising in a tubulopapillary apocrine hidradenoma of the perianal region. Eur J Dermatol 2006; 16:576-578

Gianotti R, Alessi E. Clear cell hidradenoma associated with the folliculosebaceous- apocrine unit: histologic study of five cases. Am J Dermatopathol 1997; 19:351-357

Johnson BL, Helwig EB. Eccrine acrospiroma: a clinicopathologic study. Cancer 1969; 23:641-657

Helwig EB. Eccrine acrospiroma. J Cutan Pathol 1984; 11:415-420

Hashimoto K, Dibella RJ, Lever WF. Clear cell hidradenoma: histological, histochemical and electron microscopic studies. Arch Dermatol 1967; 96:18-38

Abenoza P, Ackerman AB. Hidradenomas. In: Abenoza P, Ackerman AB, ed. Neoplasms with eccrine differentiation. Philadelphia: Lea & Febiger, 1990; 311-350

Winkelmann RK, Wolff K. Solid-cystic hidradenoma of the skin. Clinical and histopathologic study. Arch Dermatol 1968; 97:651-661

Lever WF, Castleman B. Clear cell myo-epithelioma of the skin: report of ten cases. Am J Pathol 1952; 28:691-699

Nandeesh BN, Rajalakshmi T. A Study of Histopathologic Spectrum of Nodular Hidradenoma. Am J Dermatopathol 2012; 34:461-470

Knoedler D, Susnik B, Gonyo MB, Osipov V. Giant apocrine hidradenoma of the breast. Breast J 2007; 13:91-93

Laws RA, English 3rd JC, Elston DM. Acrospiroma: a case report and review. Cutis 1996; 58:349-351

Kasbekar PU, Jadhav SP. Case study of a rare case of nodular hidradenoma of the finger. International Journal of Scientific and Research Publications 2013; 3(10):1-4

Hunt SJ, Santa Cruz DJ, Kerl H. Giant eccrine acrospiroma. J Am Acad Dermatol 1990; 23:663-668

Wolff K, Winkelmann RK, Decker RH. Solid-cystic hidradenoma: an enzyme histochemical, biochemical, and electron microscopic study. Acta Dermatol Kyoto Engl Ed 1968; 63:309-322

Ohnishi T, Watanabe S. Histogenesis of clear cell hidradenoma: immunohistochemical study of keratin expression. J Cutan Pathol 1997; 24:30-36

Lim SC, Lee MJ, Lee MS, Kee KH, et al. Giant hidradenocarcinoma: a report of malignant transformation from nodular hidradenoma. Pathol Int 1998; 48:818-823

Johnson WT, Helwig EB. Benign nevus cells in the capsule of lymph nodes. Cancer 1969; 23(3):747-753

Azzopardi JG, Ross CM, Frizzera G. Blue naevi of lymph node capsule. Histopathology 1977; 1(6):451-461

Epstein JI, Erlandson RA, Rosen PP. Nodal blue nevi. A study of three cases. Am J Surg Pathol 1984; 8(12):907-915

Bautista NC, Cohen S, Anders KH. Benign melanocytic nevus cells in axillary lymph nodes. A prospective incidence and immunohistochemical study with literature review. Am J Clin Pathol 1994; 102(1):102-108

Stefanato CM, Ferrara G et al. Hidradenoma involving the Lymphatic system. Am J Surg Pathol 2012; 36(12):1835-1840

Ko CJ, Cochran AJ, Eng W, et al. Hidradenocarcinoma: a histological and immunohistochemical study. J Cutan Pathol 2006; 33:726-730

Nazarian RM, Kapur P, Rakheja D, et al. Atypical and malignant hidradenomas: a histological and immunohistochemical study. Mod Pathol 2009; 22:600-610

Khurshid A, Yaquoob N, Devan HA, et al. ‘Nuclear groove’ in nodular hidradenoma: frequency and significance of an unrecognized histopathological feature. J Cutan Pathol 2007; 34:871-875

D'Andrea M, Reggiani C, Fasano D, Betts CM, Montanari F, Lanzoni A, Reggiani M, Foschini MP. Tumours of the skin adnexa: a case series with focus on multiple segmental forms. Pathologica 2013; 105(6):337-341

Novak NP, Kaić G, Tomasović-Loncarić C, Zic R, Skoro M, Ostović KT. Fine-needle aspiration cytology of apocrine hidradenoma. Coll Antropol 2010; 34(2):671-674.

Takasaka, Hidehisa Saeki , Keigo Ito, Koma Matsuo, Takaoki Ishiji and Hidemi Nakagawa. Skin ultrasound examination proves useful in diagnosing two cases of solid cystic hidradenoma. International Journal of Dermatology 2014; 53(2):146-147

Kleinerman R, Whang TB, Bard RL, Marmur ES. Ultrasound in dermatology: principles and applications. J Am Acad Dermatol 2012; 67(3):478-487

Jin W, Kim GY, Lew BL, Yang DM, Kim HC, Ryu JK, et al. Sonographic findings of an eccrine spiradenoma: case report and literature review. J Ultrasound Med 2008; 27:813-818

Dybiec E, Pietrzak A, Adamczyk M, Michalska-Jakubus M, Wawrzycki B, Lotti T, Rutkowski P, Krasowska D. High frequency ultrasonography of the skin and its role as an auxillary tool in diagnosis of benign and malignant cutaneous tumors - a comparison of two clinical cases. Acta Dermatovenerol Croat 2015; 23(1):43-47

Martínez-Morán C, Khedaoui R, Echeverría-García B, Borbu J. Ultrasound Image of Poroid Hidradenoma. Actas Dermosifiliogr2016; 107( 4): 349-351

Wortsman X, Moreno C, Soto R, Arellano J, Pezo C, Wortsman J. Ultrasound in-depth characterization and staging of hidradenitis suppurativa. Dermatol Surg. 2013; 39(12):1835-1842

Kazakov DV, Ivan D, Kutzner H, et al. Cutaneous hidradenocarcinoma: a clinicopathological, immunohistochemical, and molecular biologic study of 14 cases, including Her2/neu gene expression/amplification, TP53 gene mutation analysis, and t(11;19) translocation. Am J Dermatopathol 2009; 31:236-247

Peer S. The place of sonography in the diagnostic work-up of haemangiomas and vascular malformations. Handchir Mikrochir Plast Chir. 2009; 41(2):70-77

Huang S, Frydenberg M, Pham A, Grummet JP. Primary apocrine adenocarcinoma of scrotum suspected as urothelial carcinoma metastasis: A clinical and pathological dilema. Urol Ann 2015; 7(1):97-99

Sharman AM, Kirmi O, Anslow P. Imaging of the skin, subcutis, and galea aponeurotica. Semin Ultrasound CT MR. 2009; 30(6):452-464

Publicado
2018-09-11
Secção
Casos Clínicos