Apocrine tumors, benign: Five cases

Deba P Sarma, MD Omaha

Case 1

Apocrine hidrocystoma

F 45, mons pubis

Dermal cyst

Cyst wall is lined by apocrine-type epithelium with decapitation secretion

Apocrine hidrocystoma

Clinical:
Solitary cystic dermal lesion in face, eyelids, axilla, pubis, prepuce.

Pathology:
Unilocular or multilocular dermal cyst. Lined by double layers of cells: outer layer of flattened myoepithelial cells and inner columnar cells with decapitation secretion and dark basal nuclei.

Case 2

Apocrine hidrocystoma

M 80, right eyebrow

Dermal cyst lined by columnar epithelium. Cyst contains acellular fluid.

Cyst is lined by apocrine epithelium showing decapitation secretion

Apocrine hidrocystoma

Uncommon, solitary cyst derived from apocrine duct occurring on the head and neck. Unilocular or multilocular dermal cyst lined by two layers of cells: an outer layer of flattened myoepithelial cells and an inner layer of tall columnar cells with red cytoplasm and basally placed nuclei. Decapitation secretion is present. If significant papillary epithelial projections are seen within the cyst, the lesion is called an apocrine cystadenoma.

Case 3

Apocrine hidrocystoma

F 84, left temple

Comment

Uncommon, solitary cyst derived from apocrine duct occurring on the head and neck. Unilocular or multilocular dermal cyst lined by two layers of cells: an outer layer of flattened myoepithelial cells and an inner layer of tall columnar cells with red cytoplasm and basally placed nuclei. Decapitation secretion is present. If significant papillary epithelial projections are seen within the cyst, the lesion is called an apocrine cystadenoma.

Case 4

Apocrine papillary cystadenoma

F 65, right upper eyelid

Dermal cystic tumor showing untracystic papillary and solid epithelial growth pattern

Vascular stalk of the papillary groth pattern. Note the apocrine-type epithelial cells with decapitation towards the lumen.

Case 5

Apocrine spiradenoma with granular cell change

F 31, left thigh, dermal nodule

Well circumscribed, encapsulated dark dermal tumor, not connected to the epidermis. Dark dermal nodules resemble lymph node.

Tumor is composed of glandular structures lined by two layers of epithelial cells, small dark cuboidal cells and large clear cells. Stroma shows lymphocytic infiltration.

Glandular lumina contain pale eosinophilic material. Note the small dark cells and large clear cells and lymphocytes.

Note the decapitation secretion by the apocrine type epithelium.

Focally, the apocrine type epithelium shows spectacular granular cell change.

END