Malignant Acrospiroma
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Malignant Acrospiroma
Malignant acrospiroma, also known as nodular hidradenocarcinoma, malignant nodular clear-cell hidradenoma, mucoepidermoid hidradenocarcinoma, clear-cell hidradenocarcinoma, malignant clear-cell acrospiroma, and clear-cell eccrine carcinoma, is a rare and aggressive tumour of the eccrine sweat glands. It was first documented by Keasbey and Hadley in 1954. Lesions manifest as slow growing 0.5 to 10 cm nodules that may drain or ulcerate. Malignant acrospiroma can develop de novo or from a pre-existing benign lesion. The diagnosis of malignant acrospiroma is primarily based on histological, immunohistochemical, or ultrastructural characteristics. The differential diagnosis includes trichilemmal carcinoma, sebaceous carcinoma, clear cell changes in squamous cell carcinoma, basal cell carcinoma, balloon cell melanoma, porocarcinoma, and metastatic renal clear cell carcinoma. Malignant acrospiroma is treated with wide surgical excision. It has a 50% chance of recurrence and 60% c ...
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Eccrine Sweat Gland
Eccrine sweat glands (; from Greek ''ekkrinein'' 'secrete'; sometimes called merocrine glands) are the major sweat glands of the human body, found in virtually all skin, with the highest density in palm and soles, then on the head, but much less on the torso and the extremities. In other mammals, they are relatively sparse, being found mainly on hairless areas such as foot pads. They reach their peak of development in humans, where they may number 200–400/cm2 of skin surface.Bolognia, J., Jorizzo, J., & Schaffer, J. (2012). Dermatology (3rd ed., pp. 539-544). hiladelphia Elsevier Saunders. They produce a clear, odorless substance, sweat, consisting primarily of water. These are present from birth. Their secretory part is present deep inside the dermis. Eccrine glands are composed of an intraepidermal spiral duct, the "acrosyringium"; a dermal duct, consisting of a straight and coiled portion; and a secretory tubule, coiled deep in the dermis or hypodermis. The eccrine gland op ...
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Epidermis
The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water released from the body into the atmosphere through transepidermal water loss. The epidermis is composed of multiple layers of flattened cells that overlie a base layer (stratum basale) composed of columnar cells arranged perpendicularly. The layers of cells develop from stem cells in the basal layer. The human epidermis is a familiar example of epithelium, particularly a stratified squamous epithelium. The word epidermis is derived through Latin , itself and . Something related to or part of the epidermis is termed epidermal. Structure Cellular components The epidermis primarily consists of keratinocytes ( proliferating basal and differentiated suprabasal), which comprise 90% of its cells, but also contains melanocytes, Langerhans ...
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Hidrocystoma
Hidrocystoma (also known as cystadenoma, a Moll's gland cyst, and a sudoriferous cyst) is an adenoma of the sweat glands.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. . Hidrocystomas are cysts of sweat ducts, usually on the eyelids. They are not tumours (a similar-sounding lesion called hidroadenoma is a benign tumour). The three types of "sweat" glands are: True sweat glands or eccrine glands, sebaceous glands, which have an oily secretion around hair follicles, and apocrine glands, which have more oily product than eccrine glands and are found on the face, armpit, and groin. Hidrocystomas usually arise from apocrine glands. They are also called cysts of Moll or sudoriferous cysts. A type of hidroadenoma that arises from eccrine glands is uncommon. Other related conditions on the eyelids include chalazion (a granulomatous reaction to sebaceous glands on the eyelid), lacrimal duct cysts (cysts related to tear ducts), and nas ...
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Syringoma
Syringomas are benign eccrine sweat duct tumors, typically found clustered on eyelids, although they may also be found in the armpits, abdomen, chest, neck, scalp, or groin area, including genitals, in a symmetric pattern. They are skin-colored or yellowish firm, rounded bumps, 1–3 mm in diameter, and may be confused with xanthoma, milia, hidrocystoma, trichoepithelioma, and xanthelasma. They are more common in women and are most commonly found in middle-aged Asian women. While they can present at any time in life, they typically present during adolescence. They are usually not associated with any other symptoms, although can sometimes cause itchiness or irritation. Types * The eruptive form typically presents on the anterior chest, abdomen, neck, and arms. It presents in successive crops with periods of relief in between times of active rash. * The milia-like type of syringoma is typically smaller lesions that have a milky white center that can look like milia. * Th ...
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Acrospiroma
Acrospiromas are a broad class of benign cutaneous adnexal tumors. Cutaneous adnexal tumors are a group of skin tumors consisting of tissues that have differentiated (i.e. matured from stem cells) towards one or more of the four primary adnexal structures found in normal skin: hair follicles, sebaceous sweat glands, apocrine sweat glands, and eccrine sweat glands. Acrospiromas are thought to derive from apocrine or eccrine sweat gland ducts near their acrosyringium, i.e. point where these ducts open to the skin's surface. The acrosporma group of tumors consists of: 1) the hidradenomas, including their eccrine acrospiroma, clear cell hidradenoma (also termed clear cell acrospiroma), nodular hidradenoma (also termed nodular acrospiroma, clear cell myoepithelioma, and eccrine sweat gland adenoma of the clear cell type), and solid-cystic hidradenoma variants; 2) the myoepitheliomas; and 3) the poromas, particularly their dermal duct tumor (also termed dermal duct poroma) and hidroac ...
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Chemotherapy
Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a type of cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen. Chemotherapy may be given with a curative intent (which almost always involves combinations of drugs) or it may aim to prolong life or to reduce symptoms ( palliative chemotherapy). Chemotherapy is one of the major categories of the medical discipline specifically devoted to pharmacotherapy for cancer, which is called ''medical oncology''. The term ''chemotherapy'' has come to connote non-specific usage of intracellular poisons to inhibit mitosis (cell division) or induce DNA damage, which is why inhibition of DNA repair can augment chemotherapy. The connotation of the word chemotherapy excludes more selective agents that block extracellular signals (signal transduction). The development of therapies with specific molecular or genetic targets, wh ...
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Lymphadenectomy
Lymphadenectomy or lymph node dissection is the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer. In a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; in a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. Indications It is usually done because many types of cancer have a marked tendency to produce lymph node metastasis early in their natural history. This is particularly true of melanoma, head and neck cancer, differentiated thyroid cancer, breast cancer, lung cancer, gastric cancer and colorectal cancer. Famed British surgeon Berkeley Moynihan once remarked that "the surgery of cancer is not the surgery of organs; it is the surgery of the lymphatic system". The better-known examples of lymphadenectomy are ''axillary lymph node dissection'' for breast cancer; ''radical neck dissection'' for head and neck cancer and th ...
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Surgical Excision
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually spans ...
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Clear cell
In histology, a clear cell is a cell that shows a clear cytoplasm when stained with hematoxylin and eosin (H&E). Normal histology In the skin, some secretory cells in the epithelium appear as clear cells, and are one of the components of eccrine sweat glands. A clear cell's plasma membrane is highly folded, more so on the apical and lateral surfaces. The cytoplasm of clear cells contains large amounts of glycogen and many mitochondria. Melanocytes appear as clear cells when in the stratum basale of the skin, and Langerhans' cells appear as clear cells in the stratum spinosum. C cells, more commonly referred to as parafollicular cells are type of cell found in the thyroid gland which stain clear using H&E. Clear cell cancers Clear-cell adenocarcinomas are adenocarcinoma Adenocarcinoma (; plural adenocarcinomas or adenocarcinomata ) (AC) is a type of cancerous tumor that can occur in several parts of the body. It is defined as neoplasia of epithelial tissue that has glandular ...
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Necrosis
Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated digestion of cell components. In contrast, apoptosis is a naturally occurring programmed and targeted cause of cellular death. While apoptosis often provides beneficial effects to the organism, necrosis is almost always detrimental and can be fatal. Cellular death due to necrosis does not follow the apoptotic signal transduction pathway, but rather various receptors are activated and result in the loss of cell membrane integrity and an uncontrolled release of products of cell death into the extracellular space. This initiates in the surrounding tissue an inflammatory response, which attracts leukocytes and nearby phagocytes which eliminate the dead cells by phagocytosis. However, microbial damaging substances released by leukocytes would crea ...
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Epithelium
Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellular matrix. Epithelial tissues line the outer surfaces of organs and blood vessels throughout the body, as well as the inner surfaces of cavities in many internal organs. An example is the epidermis, the outermost layer of the skin. There are three principal shapes of epithelial cell: squamous (scaly), columnar, and cuboidal. These can be arranged in a singular layer of cells as simple epithelium, either squamous, columnar, or cuboidal, or in layers of two or more cells deep as stratified (layered), or ''compound'', either squamous, columnar or cuboidal. In some tissues, a layer of columnar cells may appear to be stratified due to the placement of the nuclei. This sort of tissue is called pseudostratified. All glands are made up of epithe ...
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Metastasis
Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, then, are metastases (mets). It is generally distinguished from cancer invasion, which is the direct extension and penetration by cancer cells into neighboring tissues. Cancer occurs after cells are genetically altered to proliferate rapidly and indefinitely. This uncontrolled proliferation by mitosis produces a primary heterogeneic tumour. The cells which constitute the tumor eventually undergo metaplasia, followed by dysplasia then anaplasia, resulting in a malignant phenotype. This malignancy allows for invasion into the circulation, followed by invasion to a second site for tumorigenesis. Some cancer cells known as circulating tumor cells acquire the ability to penetrate the walls of lymphatic or blood vessels, after which they are abl ...
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