Case Number : Case 546 - 12 July Posted By: Guest

[b]Hidradenoma Papilliferum[/b].

[b][color="#000000"]Hidradenoma papilliferum[/color][/b].

[color=#000000][b]Hidradenoma papilliferum[/b][/color]

I couldn't catch the maze-like architecture, hence [b]tubular apocrine adenoma[/b], both which are well-circumscribed lesions with apocrine secretion.

APOCRINE FIBROADENOMA

Though the site is typical for hidradenoma papilliferum, i think this is a Tubular apocrine adenoma in view of the lack of typical interconnecting struts of papillae, that gives the typical cribriform appearance to these lesions. This circumscribed nodule contains tubular and glandular structures of varying sizes, lined by an apocrine epithelium. There are a few papillary structures on low power, but this is consistent with a T[b]ubular apocrine adenoma.[/b] I believe that in this area, teh origin may be from the ano-genital mammary like glands. Looking forward to the right answer to this and yesterday's case please.

[font=courier new,courier,monospace][color=#000000][color=black][color=black]Hidradenoma papilliferum has a specific morphology, the arborizing trabecular pattern of the papillae hence the name. This is lacking here. It has been proposed that [/color][b][color=#231F20]most genital glandular neoplasms, including [/color][/b][color=#231F20][b]hidradenoma papilliferum[/b],[/color][b][color=#231F20] arise from mammary-like genital glands [/color][/b][color=#231F20]that share features with mammary glands and apocrine and eccrine glands. Probably genital lesions “reported as” [/color][color=black]apocrine adenoma[/color][color=#636363] [/color][color=black]and apocrine fibroadenoma are merely [b]variants of adenomas of anogenital mammary-like glands[/b]. [/color][/color][/color][/font]

[size=4][font=courier new,courier,monospace][color=#222222]Thank you [/color][/font][/size]

I have edited Phillips post for reasons that will become obvious!
Phillp writes...
Sorry about yesterday's spot diagnosis but I was away for the day and it should have been dealt with in my absence. Anyway, yesterday's case was one of Richard's which he kindly gave me.
It was indeed and incidental finding of an injected cosmetic filler in a man with actinic cheilitis.
Today's case is really one of somantics. It was reported as a hidradenoma papilliferum and I imagine if deeper sections had been examined (and they probably were as the section I photographed was a recut and the whole lesion had probably been partially cut out) there would have been all the classic changes. Hidradenoma papilliferum and apocrine tubular adenoma are really just variations on the theme and it is not to my mind of huge consequence which term you apply although it is traditional to use the term hidraneoma papilliferum when dealing with vulval tumors. I have certainly seen tubular adenomas on the scalp that were very reminiscent of HP. As for histogenesis, certainly many folk (but by no means all) beleive this tumor to derive from the mammary-like genital glands.
On a different note, it would be really great if when you visit the site, you have a look at the blogs and more importantly make a comment. This is a very "alive" component of the site and your views are going to be very much appreciated. The more comments we have the better and more dynamic it will be.