E-mail: ri. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Clear cell hidradenoma or nodulocystic hidradenoma or acrospiroma are histologically distinct relatively rare tumors of sweat gland duct origin, found mainly in adults with a female preponderance. We report a case of eccrine hidradenoma in a year-old man who presented with an asymptomatic, solitary nodule on occipital region. A few reports are available in literature regarding presence of this tumor on occipital region of young man and present case is being reported because of its rarity in this region of scalp and in this sex. Although traditionally regarded as displaying eccrine differentiation, it is now accepted that tumors can show either eccrine or apocrine differentiation.

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Corresponding author. Correspondence: Euna Hwang. This article has been cited by other articles in PMC. Eccrine hidradenoma is a rare benign cutaneous neoplasm, believed to arise from the distal excretory duct of the eccrine sweat glands [ 1 ]. Because a consensus has not been reached regarding its histogenesis, eccrine hidradenoma is also known as nodular hidradenoma, clear cell hidradenoma, eccrine acrospiroma, and eccrine sweat gland adenoma.

It usually manifests as an asymptomatic, solitary, firm, cutaneous nodule, measuring between 5 mm and 20 mm in diameter. The tumor is usually confined to the dermis or subcutaneous layer without involving the deep structures. It occurs commonly in middle-aged and older adults, and can be found anywhere on the body without predilection for a particular site [ 2 ].

Its growth is slow, and a malignant change is rare. Several reports of giant eccrine hidradenoma can be found in the literature [ 3 , 4 ]. However, a case of a benign giant eccrine hidradenoma infiltrating the deeper structures beyond the muscle layer to the cranial base has not been reported thus far.

Herein, we report a case of a benign giant nodular eccrine hidradenoma in the preauricular area that had infiltrated deep structures and extended into the cranial base. He had difficulty opening his mouth and closing his right eyelid. A physical examination revealed a loss of forehead wrinkles, eyebrow ptosis, mild ectropion of the lower eyelid, and mild depression of the mouth corner on the right side of his face, which were consistent with facial nerve paralysis House-Brackman grade IV Fig.

The mass first appeared approximately 30 years ago, and the patient previously had the mass surgically excised at another clinic approximately 5 years previously. The tumor had slowly grown again over the last couple of years. Laboratory findings including all hematologic and biochemical examinations showed no abnormalities. A computed tomography CT scan revealed a large mass occupying the parotid space, masticatory space, and temporal region with infiltration into the temporalis muscle.

The tumor mass compressed the internal jugular vein, displaced the external carotid artery inferiorly, and extended to the cranial base around the right foramen ovale without intracranial extension Fig. In the magnetic resonance imaging MRI scan, this heterogeneous tumor showed homogeneous enhancement and focal internal calcifications. Although CT and MRI findings indicated a malignancy of the salivary gland invading deep structures with regional metastasis, the result of a preliminary excisional biopsy of this tumor was consistent with a benign eccrine hidradenoma.


Giant Eccrine Hidradenoma Mimicking a Malignant Tumor of the Salivary Gland

Introduction Sweat gland lesions originate from sweat gland or sweat duct cell lines. They are classified by their histological features. What are sweat glands? There are two types of sweat glands: eccrine glands and apocrine glands. Eccrine and apocrine glands, hair follicles and sebaceous glands which produce sebum are often referred to as epidermal adnexal structures. Sweat gland lesions generally have variable apocrine or eccrine differentiation. Traditionally these lesions have been categorized under either the apocrine or eccrine groups, but significant overlaps do exist.


Sweat gland lesions

These lesions are uncommon on the eyelids. They presumably arise from eccrine sweat glands and do not show any apocrine differentiation. These tumors occur primarily in middle-aged females and have a predilection for the head region. Very rarely they may undergo malignant change. Occasionally it may be exophytic in growth with a translucent appearance and fine telangiectatic vessels. Some lesions have been known to undergo spontaneous regression.


Clear cell hidradenoma


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