Spiradenoma L74.8

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

Spiradenocylindrome; Spiradenoma eccrines

History
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Hellwig and Kersting, 1956

Definition
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Rare, undifferentiated or slightly differentiated, benign (apparently pluripotent) adnexal tumor with predominantly eccrine differentiation. Apocrine, occasionally follicular differentiation is possible. Against the (exclusively) eccrine genesis speaks the observation that spiradenomas occur very rarely on the palms of the hands and soles of the feet.

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Manifestation
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Mostly occurring in 20- to 40-year-old adults.

Localization
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Especially the head, neck, upper torso or sides of the arms are affected.

Clinical features
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Usually solitary, round, 0.5-3 cm large, coarse, skin-coloured to livid red, sharply defined, rarely spontaneously or under pressure painful tumour with a smooth surface. Multiple, disseminated or linearly arranged tumours are rare. The clinical picture is, apart from the possible painfulness, not very characteristic. The diagnosis is usually a histological accidental finding.

Histology
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Very distinct histological morphology. Nodular tumour complex located in the deep dermis and surrounded by a fibrous connective tissue capsule, partly consisting of one or more nodes. The parenchyma consists of basaloid, poorly differentiated cell complexes. Detection of centrally located cells with large, pale nuclei and slightly basophilic cytoplasm and smaller cells with hyperchromatic nuclei in the marginal area. Often a clear lymphocytic accompanying infiltrate is present.

Differential diagnosis
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Leiomyoma; glomus tumor. S.u. ANGLES for other pressure painful tumours of the skin.

Therapy
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Excision in toto is curative.

Note(s)
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Spiradenomas often occur together with cylindromas, possibly both together with trichoepitheliomas and trichoblastomas (see Brooke-Spiegler syndrome below). Recently, spiradenoma and cylindrome have been regarded as one entity, which are summarized under the term spiradenocylindrome.

Literature
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Eich N et al (1985) The eccrine spiradenoma. dermatologist 36: 240-241
Kersting E, Helwig EB (1956) Eccrine spiradenoma. Arch Dermatol 73: 199-227
Granter SR et al (2000) Malignant eccrine spiradenoma (spiradenocarcinoma): a clinicopathologic study of 12 cases. At J Dermatopathol 22: 97-103
Leonard N et al (2003) Low-grade malignant eccrine spiradenoma with systemic metastases. At J Dermatopathol 25: 253-255
Massoumi R et al (2006) Cylindroma as tumor of hair follicle origin.J Invest Dermatol. 2006 May;126(5):1182-1184
Mirza I et al (2002) Malignant eccrine spiradenoma. Arch Catholic Lab Med 126: 591-594
Rose C (2014) tumors of the scalp. Special aspects of selected examples. Dermatologist 65: 1030-1036
Ter Poorten MC et al (2003) Familial eccrine spiradenoma: a case report and review of the literature. Dermatol Surgery 29: 411-414