Spiradenomas stem from eccrine and apocrine glands to form benign cutaneous tumors. When arising on the breast, nipple, and areola region, spiradenomas can be difficult to differentiate from more worrisome breast masses. This is particularly true in patients with a prior history of breast cancer. These tumors can be mimicked by a wide range of adnexal growths and play a role in syndromic conditions. We present a case of a 56-year-old female with a 20-year enlarging left lower inner quadrant breast mass reviewed on mammography which was later excised and histopathologically diagnosed as a spiradenoma. Spiradenomas can be challenging to diagnose as they can present with similar findings on inexpensive and non-invasive testing such as ultrasound and mammogram. While a biopsy is a definitive tool for diagnosis, this is contraindicated in some spiradenoma mimickers such as epidermal cysts complicating diagnosis. To our knowledge, there are only six case reports of breast spiradenomas. We have reviewed the histopathology of this case and summarized all cases of breast spiradenomas and their malignant counterpart spiradenocarcinomas available in the literature compiling their presentations and imaging findings.
CONFLICTS OF INTEREST DISCLOSURE
The authors declare that they have no competing interest.
| [1] |
Gomez A, Moratalla CN, Ferrer F, et al. Malignant eccrine breast spiradenoma. A case report and literature review. Int J Surg Case Rep. 2015; 15: 81-84. PMid:26318134. https://doi.org/10.1016/j.ijscr.2015.08.017
|
| [2] |
Bosch M, Boon M. Fine-needle cytology of an eccrine spiradenoma of the breast: Diagnosis made by a holistic approach. Diagn Cytopathol. 1992; 8(4): 366-368. PMid:1322262. https://doi.org/10.1002/dc.2840080412
|
| [3] |
Benedict M, Ozerdem U. Case Report Eccrine spiradenoma arising from the breast skin. Case Rep Pathol. 2015; 2015: 615158. PMid:26236527. https://doi.org/10.1155/2015/615158
|
| [4] |
Naversen D, Trask D, Watson F, et al. Painful tumors of the skin: "lend an egg”. J Am Acad Dermatol. 1993; 2(Pt 2): 298-300. https://doi.org/10.1016/0190-9622(93)70039-V
|
| [5] |
Jukic D, Drogowski L, Davie J. Carcinoma ex Spiradenoma/ Cylindroma confirmed by immunohistochemical and molecular loss-of-heterozygosity profiling. Am J Dermatopathol. 2009; 31(7). PMid:19684510. https://doi.org/10.1097/DAD.0b013e3181a6b6f4
|
| [6] |
Vanecek T, Halbhuber Z, Kacerovska D, et al. Large germline deletions of the CYLD gene in patients with Brooke-Spiegler syndrome and multiple familial trichoepithelioma. Am J Dermatopathol. 2014; 36(11): 868-874. PMid:25347032. https://doi.org/10.1097/DAD.0000000000000068
|
| [7] |
Blake P, Torro J. Update of cylindromatosis gene (CYLD) mutations in brooke-spiegler syndrome: Novel insights into the role of deubiquitination in cell signaling. Hum Mutat. 2009; 30(7): 1025-1036. PMid:19462465. https://doi.org/10.1002/humu.21024
|
| [8] |
Ribeiro-Silva A, Shaletich C, Careta R, et al. Spiradenocarcinoma of the breast arising in a long-standing spiradenoma. Ann Diagn Pathol. 2004; 8(3): 162-166. PMid:15185264. https://doi.org/10.1016/j.anndiagpath.2004.03.007
|
| [9] |
Kanwaljeet S, Chatterjee T. Eccrine spiradenoma: A rare adnexal tumor. Indian J Cancer. 2017; 54(4): 695-696. PMid:30082561. https://doi.org/10.4103/ijc.IJC_301_17
|
| [10] |
Lee H, Park S, Choi H, et al. Eccrine spiradenoma arising in the breast misdiagnosed as an epidermal inclusion cyst. Korean J Radiol. 2011; 12(2): 256-60. PMid:21430945. https://doi.org/10.3348/kjr.2011.12.2.256
|
| [11] |
Park H, Im S, Shin D, et al. Painful eccrine spiradenoma containing nerve fibers: A case report. Dermatology. 2012; 224(4): 301-306. PMid:22777362. https://doi.org/10.1159/000339768
|
| [12] |
Gingrich A, Fung M, Konia T, et al. Locally advanced spiroadenocarcinoma in the regional axilla of a breast cancer patient: Hallmarks of definitive diagnosis and management. Rare Tumors. 2015; 7(3): 5912. PMid:26500731. https://doi.org/10.4081/rt.2015.5912
|
| [13] |
Son J, Choi Y, Cho Y, et al. A case of eccrine spiradenoma: A rarely seen soft tissue tumor on the extensor surface of arm. Ann Dermatol. 2017; 29(4): 519-522. PMid:28761313. https://doi.org/10.5021/ad.2017.29.4.519
|
| [14] |
Draheim J, Neubecker R, Sprinz H. An unusual tumor of the breast resembling eccrine spiradenoma. Am J Clin Pathol. 1959; 31(6): 511-516. PMid:13661107. https://doi.org/10.1093/ajcp/31.6.511
|
| [15] |
Metovic J, Gallino C, Zanon E, et al. Eccrine spiradenoma of the nipple: Case report, differential diagnosis and literature review. Histol Histopathol. 2019; 18094.
|
| [16] |
Panico L, D’Antonio A, Chiacchio R, et al. An unusual, recurring breast tumor With Features of eccrine Spiradenoma A case report. Am J Clin Pathol. 1996; 106(5): 665-669. PMid:8929479. https://doi.org/10.1093/ajcp/106.5.665
|
| [17] |
Saboorian M, Kenny M, Ashfaq R, et al. Carcinosarcoma arising in eccrine spiradenoma of the breast. report of a case and review of the literature. Arch Pathol Lab Med. 1996; 120(5): 501-504.
|
| [18] |
Tanaka Y, Bhunchet E, Shibata T. A case of malignant eccrine spiradenoma metastatic to intramammary lymph node. 2008; 15(2): 175-180. PMid:18270794. https://doi.org/10.1007/s12282-007-0023-y
|
| [19] |
Thomas B, Duwel V, Proot L, et al. An uncommon breast tumour: The malignant eccrine spiradenoma. A case report. Acta Chir Belg. 1993; 93(6): 295-298.
|
| [20] |
Giess CS, Raza S, Birdwell RL. Distinguishing Breast Skin Lesions from Superficial Breast Parenchymal Lesions: Diagnostic Criteria, Imaging Characteristics, and Pitfalls. RadioGraphics. 2011; 31(7): 1959-1972. PMid:22084181. https://doi.org/10.1148/rg.317115116
|