Malignant Hidradenocarcinoma Initially Diagnosed as an Apocrine Hidrocystoma: a Case Report and Literature Review
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CASE REPORT
Malignant Hidradenocarcinoma Initially Diagnosed as an Apocrine Hidrocystoma: a Case Report and Literature Review Jung Sik Choi 1 & Na Rim Kim 1 & Jean A. Kim 2 & Jung Ho Lee 1 Received: 9 October 2019 / Accepted: 8 April 2020 # Association of Surgeons of India 2020
Abstract Hidradenocarcinoma is a rare malignant tumor with an aggressive clinical course, and it accounts for < 0.05% of all malignant tumors. It is known to mainly develop de novo, and rarely seen observed to arise from an existing hidradenoma. In this report, we describe a rare case of hidradenocarcinoma that was initially diagnosed as an apocrine hidrocystoma on punch biopsy. During follow-up, the lesion recurred, and complete excision biopsy confirmed the diagnosis of hidradenocarcinoma. Because of the aggressive nature of the disease, we performed wide excision of the lesion, and the defect was reconstructed with a thin free anterolateral thigh perforator flap. No evidence of recurrence was observed during the 11-month follow-up period. Keywords Hidradenocarcinoma . Hidrocystoma . Reconstruction . Sweat gland tumor
Introduction Hidradenocarcinoma is a very rare malignancy and is estimated to account for < 0.05% of all malignant tumors [1]. It mainly develops de novo and is rarely observed to arise from an existing hidradenoma [2]. Because of its aggressive nature, early recognition and surgical treatment is important for the cure of hidradenocarcinoma. In this case, we will present a case of hidradenocarcinoma that was initially diagnosed as an apocrine hidrocystoma on punch biopsy. By good luck, we could perform excisional biopsy for the lesion during the early follow-up period, and the malignant component could be found. However, if the patient was not followed up properly, the diagnosis and proper treatment could be delayed. We think any other physicians can encounter this situation and suffer from complaint of the delay or legal issue. In this report, we will inform some points in
* Jung Ho Lee [email protected] 1
Department of Plastic and Reconstructive Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon, Gyeonggi 14647, Republic of Korea
2
Department of Clinical Pathology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea
diagnosing and treating the hidradenocarcinoma with a review of relevant literatures.
Case Report A 62-year-old male patient visited our clinic with a complaint of a 1-cm-sized erythematous, elevated lesion on his left cheek (Fig. 1a). He could not recall the exact period of onset of the lesion but reported that the lesion had become noticeable 2 months before his visit. A 3-mm-punch biopsy of the lesion was performed, and apocrine hidrocystoma was diagnosed on the basis of histopathological findings (Fig. 1b). Because of the benign nature of the lesion, we did not recommend further surgery and decided to monitor the patient regularly. However, during the first month o
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