Case Number : Case 1757 - 21 February - Dr Uma Sundram Posted By: Guest

Dr Uma Sundram provides today's Spot Diagnosis Case to test you all, enjoy

Geoff Cross - DermpathPRO Projects

Even though there is something of clear cell variant of BCC ( peritumoral stromal retraction  and peripheral epithelial palisades ) I think of an adnexal benign tumor of ductal sweet glands: a Clear Cell variant of Nodular Hidradenoma. There's a MF in last fig, but hidradenoma may contain some mitosis.

Nice similarity to canalicular basal cell adenoma of salivary glands. 

Hidradenoma my first thought

I thought of hidradenoma ,too

A solid tumor composed of epithelial cells with clear eosinophilic cytoplasm which are arranged in an, at least focally, intriguing trabecular/labyrinthine pattern usually seen in sebaceous tumors. Although I didn’t find unequivocal evidence of glandular/ductal differentiation nor the typical hyalinized stroma, I agree this is hidradenoma.

I though of hidradenoma with clear cell change but would also do immunos to rule out trichoblastoma with prominent clear cell change

? Rippled pattern sebaceoma

I'm thinking clear cell hidradenoma or trichoblastoma

Hidradenoma with clear cell change.

17 hours ago, Raul Perret said:

I though of hidradenoma with clear cell change but would also do immunos to rule out trichoblastoma with prominent clear cell change

agree

Hidradenoma with clear cell change.  I sent this case in consultation to Dr. Mark Wick who agreed with the diagnosis. Adipophilin was negative.