Apocrine tumors, benign:

Five cases

Deba P Sarma, MD
Omaha
Case 1

Apocrine hidrocystoma
F 45, mons pubis

Dermal cyst
Cyst wall is lined by apocrine-type epithelium with decapitation secretion
 Apocrine hidrocystoma

 Clinical:
 Solitary cystic dermal lesion in face, eyelids, axilla, pubis,
prepuce.

 Pathology:
 Unilocular or multilocular dermal cyst.
 Lined by double layers of cells: outer layer of flattened
myoepithelial cells and inner columnar cells with
decapitation secretion and dark basal nuclei.
Case 2

Apocrine hidrocystoma
 M 80, right eyebrow

Dermal cyst lined by columnar epithelium.

Cyst contains acellular fluid.
Cyst is lined by apocrine epithelium showing decapitation secretion
Apocrine hidrocystoma

 Uncommon, solitary cyst derived from

apocrine duct occurring on the head and
neck.
 Unilocular or multilocular dermal cyst
lined by two layers of cells: an outer layer
of flattened myoepithelial cells and an
inner layer of tall columnar cells with red
cytoplasm and basally placed nuclei.
 Decapitation secretion is present. If
significant papillary epithelial projections
are seen within the cyst, the lesion is
called an apocrine cystadenoma.
 Case 3

Apocrine hidrocystoma
F 84, left temple
 Comment
 Uncommon, solitary cyst derived from apocrine duct
occurring on the head and neck.
 Unilocular or multilocular dermal cyst lined by two layers of
cells: an outer layer of flattened myoepithelial cells and an
inner layer of tall columnar cells with red cytoplasm and
basally placed nuclei.
 Decapitation secretion is present. If significant papillary
epithelial projections are seen within the cyst, the lesion is
called an apocrine cystadenoma.
Case 4

Apocrine papillary cystadenoma

F 65, right upper eyelid

Dermal cystic tumor showing untracystic papillary and solid epithelial

growth pattern
Vascular stalk of the papillary groth pattern.
Note the apocrine-type epithelial cells with decapitation towards the
lumen.
Case 5

Apocrine spiradenoma with granular

cell change
F 31, left thigh, dermal nodule

Well circumscribed, encapsulated dark dermal tumor, not connected to the epidermis.
Dark dermal nodules resemble lymph node.
Tumor is composed of glandular structures lined by two layers of epithelial cells,
small dark cuboidal cells and large clear cells. Stroma shows lymphocytic
infiltration.
Glandular lumina contain pale eosinophilic material. Note
the small dark cells and large clear cells and lymphocytes.
Note the decapitation secretion by the apocrine type epithelium.
Focally, the apocrine type epithelium shows spectacular granular cell change.
END