|LETTER TO THE EDITOR
|Year : 2016 | Volume
| Issue : 3 | Page : 416-417
Poroid hidradenoma: An unusual presentation
Department of Pathology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
|Date of Web Publication||17-May-2016|
521/177, Bhairon Prasad Marg, Bara Chand Ganj, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Awasthi N. Poroid hidradenoma: An unusual presentation. Med J DY Patil Univ 2016;9:416-7
The term "poroma" refers to a group of benign cutaneous adnexal neoplasms with "poroid" or terminal ductal differentiation. Four histopathologic variants have been identified depending on location of the tumor cells: Hidradenoma simplex, eccrine poroma, dermal duct tumor and poroid hidradenoma. ,, Recent studies have shown a common histogenesis for all these variants. 
A 45-year-old male presented to the surgical outpatient department with a gradually increasing swelling of 1-year duration, over right lower anterior abdominal wall. There were no other associated symptoms. On examination, there was a 3 cm × 3 cm, mobile, nontender, erythematous lump arising from anterior abdominal wall of right iliac fossa. His past medical and family history were unremarkable. A clinical diagnosis of infected sebaceous cyst was made. The nodular swelling was excised under local anesthesia and was sent for histopathological examination.
Macroscopic examination showed a skin covered soft tissue mass measuring 3 cm × 2.5 cm × 1.5 cm. Cut surface showed a sub-epidermal, well-circumscribed, solid grayish white tumor with multiple small cystic foci [Figure 1]. Microscopic examination revealed a well-circumscribed, lobulated, intra-dermal, solid-cystic tumor, with no apparent connection to the overlying epidermis [Figure 2]. The tumor was composed of, small and dark staining poroid cells having round to oval nuclei, indistinct nucleoli with scant eosinophilic cytoplasm [Figure 3] and cuticular cells having round nuclei, distinct nucleoli with abundant eosinophilic cytoplasm. Cuticular cells showed evidence of ductal differentiation at places [Figure 4]. Focal areas showed glandular structures lined by columnar to cuboidal cells with clear cell change at places, cystic spaces filled with eosinophilic material, [Figure 1] irregular ectatic vessels and stromal infiltration by lymphocytes and plasma cells. Histomorphological findings were compatible with poroid hidradenoma. The postoperative period was uneventful and the patient was doing well after 2 months of surgery.
|Figure 2: Low power examination: (H & E, ×100), intra-dermal, solid-cystic tumor. Cystic spaces containing eosinophilic material shown by white arrows|
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|Figure 4: H & E, ×400 showing cuticular cells with ductal differentiation|
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Poroid hidradenoma is an uncommon variant of Poromas described by Abenoza and Ackerman in 1990, ,, occurring over a wide age range from 17 to 91 years,  with a peak in the seventh decade. It presents clinically as a solitary, circumscribed, intra-dermal nodule. Histopathologically, these are hybrid lesions, showing cytological characteristics of poromas with poroid and cuticular cells  and architectural features of hidradenoma, which is an intra-dermal, solid-cystic tumor.  Some reports have stressed on the role of fine needle aspiration cytology in the diagnosis of these solid-cystic tumors.  To date, few cases of poroid hidradenoma have been reported in the literature. ,
To conclude, Poroid hidradenoma is an uncommon benign adnexal tumor which can present clinically as a cystic lesion. It should be considered in the differential diagnosis of cutaneous solid-cystic lesions preoperatively, so that adequate surgical excision is done and recurrences are prevented.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]