Clear Cell Hidradenocarcinoma: a Rare Identity Difficult to Recognize - Case Report and Review of the Literature

Abstract

Hidradenocarcinoma (HC) is a malignant and aggressive sweat gland tumour. It is a rare occurrence, accounting for about 6% of malignant eccrine cancers and less than 1% of all cutaneous neoplasms. It is a malignant tumor which can manifest itself in any area of the body, including the anterior surface of the trunk, the torso, scalp, face, and extremities. It is apparent that HC has a high propensity for lymphatic metastasis. The suggested treatment approach for HC implies making a wide surgical excision with negative margins. Nevertheless, such tumours are aggressive and recur locally in 50% of cases; they also produce metastases in 60% of cases. The overall five-year survival rate is 30%. Here, we present the case of a 68-year-old Caucasian male with unknown diagnosis of malignant neoplasm of inguinal cutaneous skin of sweat gland called hydrocarcinoma.

FIGURE 1.

Computed tomography followed by magnetic resonance imaging confirming the presence of the mass and showing ipsilateral iliac-femoral lymphadenopathy

FIGURE 2.

a, b, c, d. Histological sections indicating anastomising cords and lobulated masses of cells with a polygonal to slightly fusiform shape, whereas most cells appear as bland ovoid nuclei with slightly eosinophilic to clear cytoplasm. Focal areas within the lesion may demonstrate malignant changes, and possibly show several mitotic figures, large pleomorphic hyperchromatic nuclei, with a tendency towards squamous differentiation with numerous neoplastic cells indicating individual keratinisation.