Mammary-Like Gland Adenoma: Hidradenoma Papilliferum
Mammary-like gland adenoma (hidradenoma papilliferum) is a rare benign tumor arising from mammary-like anogenital glands. The etiology is unknown, but these tumors are the most common vulvar adnexal lesion. The lesions are often asymptomatic slow-growing
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Amanda Selk, David Nunns, and Sandra Ronger Savle
32.1 Introduction
32.3 Clinical Presentation
Mammary-like gland adenoma (hidradenoma papilliferum) is a rare benign tumor. These tumors were previously thought to arise from apocrine sweat glands but are now thought to be adenomas of mammary-like anogenital glands [1].
Hidradenoma papilliferum usually presents as an asymptomatic, slow-growing nodule, in middle- aged women [1]. The lesions are skin colored or red and located on the vulva or perianal area [1]. When lesions appear in the vulva, they often develop in the interlabial sulcus or adjacent on the perineum [1, 6] (Figs. 32.1 and 32.2). The lesions can ulcerate or bleed which can lead them
32.2 Pathogenesis The etiology of hidradenoma papilliferum is unknown. In a single institution review, they were found to be the most common vulvar adnexal lesions [2]. Excised vulvar specimens have shown histologic and immunochemical staining similar to that seen in breast tissue [3–5]. Hidradenoma is usually seen between 30 and 49 years.
A. Selk (*) Women’s College Hospital, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada D. Nunns Department of Gynaecological Oncology, Nottingham University Hospital, Nottingham, UK S. Ronger Savle Department of Dermatology and Gynecology, Lyon 1 University and Centre Hospitalier Lyon Sud, Pierre Bénite, Lyon, France
Fig. 32.1 Hidradenoma papilliferum, a skin-colored 3 mm nodule on the left labia minora
© Springer International Publishing AG, part of Springer Nature 2019 J. Bornstein (ed.), Vulvar Disease, https://doi.org/10.1007/978-3-319-61621-6_32
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References
Fig. 32.2 Hidradenoma papilliferum between the right labia minora and labia majora
to be confused with malignancy, and they should be excised or biopsied in this circumstance [7].
32.4 Treatment Treatment is not required except for cosmetic reasons or if there are concerning signs for malignancy such as ulceration, bleeding, pain, a lesion that is growing, etc. [1, 7, 8]. If treatment is desired, the lesion is excised surgically, and the condition is generally cured and not recurrent. Hidradenoma Papilliferum: Breaking the Myth
• Hidradenoma papilliferum may have alarming glandular features in histopathological examination. However, it is a benign tumor.
1. El-Khoury J, Renald MH, Plantier F, Avril MF, Moyal-Barracco M. Vulvar hidradenoma papilliferum (HP) is located on the sites of mammarylike anogenital glands (MLAGs): analysis of the photographs of 52 tumors. J Am Acad Dermatol. 2016;75(2):380–4. 2. Baker GM, Selim MA, Hoang MP. Vulvar adnexal lesions: a 32-year, single-institution review from Massachusetts General Hospital. Arch Pathol Lab Med. 2013;137(9):1237–46. 3. Konstantinova AM, Kyrpychova L, Belousova IE, et al. Anogenital mammary-like glands: a study of their normal histology with emphasis on glandular depth, presence of columnar epithelial cells, and distribution of elastic fibers. Am J Dermatopathol. 2016;39(9):663–7. 4. Konstantinova AM, Michal M
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