INTRODUCTION Apocrine adenomas, also known as apocrine cystadenoma, are rare adnexal tumors that arise from apocrine Moll glands and ducts. The cystadenoma is derived from secretory epithelium, whereas the specific subtype tubular apocrine adenoma consists mainly of tubules with apocrine epithelium. More than 90% of such lesions occur on the face and scalp. Cystic spaces develop with lipid-rich decapitation material as found in apocrine cysts. Rarely, these lesions can undergo malignant change.
CLINICAL PRESENTATION Apocrine adenomas are slow growing, single or multiple well-circumscribed dome-shaped or papillomatous dermal lesions. They can be solid or they may be cystic with a superior dome of yellowish or creamy material. These lesions occur more often on the eyelid margins where Moll glands are more abundant.
HISTOPATHOLOGY The tubular variant of apocrine adenoma presents as a well-circumscribed intradermal nodule. The tumor is composed of variably-sized tubules usually composed of a double layer of cells with eosinophilic cytoplasm and round to oval nuclei. The inner lining of cells has prominent decapitation secretion characteristic of apocrine differentiation. Mitoses are rare and cellular pleomorphism is absent.
DIFFERENTIAL DIAGNOSIS The differential diagnosis includes many dermal lesions such as syringoma, apocrine adenocarcinoma, nodular hidradenoma, fibroadenoma, sebaceous cell carcinoma, mucinous adenocarcinoma, myxoid chondrosarcoma, trichilemmal cyst, and trichoepithepthelioma.
TREATMENT Treatment is usually not required unless the lesion is large and of cosmetic concern or functionally interferes with eyelid function. Surgical excision is easily accomplished. Trichloroacetic acid chemical ablation and electrocautery have also been reported to give good results. The diode laser has been advocated for facial lesions.
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This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.