Case Number : Case 1064 - 22nd July Posted By: Guest

Tubular adenoma.

Tubular adenoma

Agree, tubular adenoma.

Agree with tubular adenoma

Tubular adenoma.

[quote name='I. Abdul-kadir' timestamp='1406020719']
Tubular adenoma.
[/quote]
Ditto.

Agree, tubular adenoma.

Is there a differential?

Could it be weird breast carcinoma? The cytology is pretty bland.

Other differential diagnosis could be Siringoma.

I thought I would be a minority opinion on this case, and I am. Here is my diagnosis and comment:

[b]-- SYRINGOMATOUS CARCINOMA [/b]
[indent=1][b]COMMENT:[/b] Syringomatous carcinoma is the malignant analog of syringoma and presents, in most cases, much as it has presented in this particular case. The main differences between syringomatous carcinoma and microcystic carcinoma are that the microcystic carcinomas tend to have a morula pattern superficially and tend to have a dense collection of infiltrative strands and cords of ductal cells in the deep part – which produces a gradient effect, in contrast with the case for review here. Syringomatous carcinomas usually are indolent biologically, but they do have the capacity to metastasize, as there are some rare examples that have been presented in the literature. “Trichoadenomas” (which are actually infundibular) have much more of an infundibular pattern than a tubular or ductal pattern. I have not seen mucoepidermoid carcinoma much in the skin, but I can say that they are not as organized as is the lesion under review here.[/indent]

[center][u]Reference[/u]:[/center]

Requena L, Kiryu H, Ackerman AB. Syringomatous carcinoma. in [i]Neoplasms With Apocrine Differentiation[/i]. Philadelphia, Lippincott-Raven-Ardor Scriebendi, 1998: 771-783.

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My impression was eccrine ductal carcinoma (syringoid carcinoma). Thank you for sharing a rare one!