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Case Reports
. 2025 Feb 17:59:22-25.
doi: 10.1016/j.jdcr.2025.01.022. eCollection 2025 May.

PRAME positive spiradenocarcinoma treated with Mohs micrographic surgery

Austinn C Miller  1   2 , John S Acosta-Peñaloza  3 , Monica Constantinescu  1   2   4 , András Schaffer  1   2   3   4 , Armand B Cognetta Jr  1   2   3   4
Affiliations
Case Reports

PRAME positive spiradenocarcinoma treated with Mohs micrographic surgery

Austinn C Miller et al. JAAD Case Rep. .
No abstract available

Keywords: Mohs Micrographic Surgery; PRAME; malignant eccrine spiradenoma; spiradenocarcinoma.

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Conflict of interest statement

None disclosed.

Figures

Fig 1
Fig 1
Firm, mobile, irregular, 2 cm dermal/subdermal nodule with a dusky red hue on the radial aspect of the left forearm.
Fig 2
Fig 2
A, Excisional biopsy shows well-circumscribed multinodular structure in pushing downward on subcutis. H&E, 2×. B, Higher power view demonstrates fascicles separating dense cellular islands. H&E, 10×. C and D, Architecture recapitulates that of a benign spiradenoma, with 2 types of basaloid cells: small, dark blue nuclei and large, pale blue nuclei, some forming circular rosettes of basaloid cells arranged around pink hyalinized stroma and intermixed with small sweat ducts. However, tumor islands show increased mitotic figures, nuclear pleomorphism, and prominent nucleoli. Focal comedo necrosis is visible, highlighting malignant change. H&E, 20×.
Fig 3
Fig 3
A, Increased Ki-67 proliferation index, up to 40% in malignant areas. B, Ki-67 positivity in atypical lesional cells. C, p53 expression is positive in carcinomatous areas (nuclear stain). D, p53 is over-expressed within malignant cells. E, PRAME shows >70% positivity in lesional cells. F, PRAME expression in malignant areas.
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