Eccrine spiradenoma: causes, symptoms, diagnosis, treatment

Ekrinna spiradenoma is a fairly rare tumor, which often occurs in middle-aged and young people - up to 40 years (72%), in children under 10 years (10.8%), approximately in equal proportions in men and women.

Symptoms of ekrinnoy spiradenoma. The localization of the tumor is ubiquitous, mainly on the skin of the head, upper parts of the trunk, except for the skin of the palms, the nail bed, the areola of the nipple, the labia, the foreskin. Solitary formations predominate.

Clinical manifestations of ekkrinnoy spiradenoma are quite diverse - a tumor can arise as an intradermal node that rises above the level of the surrounding skin. The surface of the skin over the protruding node can be unchanged or acquire a brownish hue. Another clinical variant is possible in the form of an exophytic hemispherical node on a broad base with a smooth or slightly bumpy pinkish surface or a knot on a narrower base with a translucent wall of light gray or bluish tinge. There is a weak or moderately expressed sensitivity of the tumor to tactile or temperature effects. Soreness can appear spontaneously in the form of short-term attacks. About 5% of tumors ulcerate and bleed. A rare variant of this tumor is the multiple zosteriformal ecrinic spiradenoma.

Pathomorphology of the ecrina spiradenoma. The tumor is characterized by multiple encapsulated nodules and dermis, consisting of two main types of cells - larger ones with light vesicular nuclei and moderately basophilic cytoplasm, the so-called light cells, and small, dark cells with scant cytoplasm and hyperchromic nuclei. The latter occupy the peripheral position in relation to the first, forming palisad-like structures. "Dark" and "light" cells can be located in nodes without any orientation or form structures in the form of tubules, the central part of which was "light" cells, and on the periphery in one row are located "dark" cells. 1976) identified 6 histological variants of the structure of the ecrina spiradenoma: solid, tubular, glandular, cylindrhythmic, angiomatous, mixed .Increased hormone vessels of sinusoidal type filled with blood or lymph-like fluid are pathognomonic for ekkrina.

Histogenesis of ekrinnoy spiradenoma. An ultrastructural study showed that there are two types of cells in a tumor: undifferentiated basaloid cells with small dark nuclei and differentiated cells with large light nuclei. Most differentiated cells are immature. In most cases, the ductal structures predominate, the luminal surface of which is covered with short, densely located microvilli, which is a sign of intradermal duct differentiation. Around the lumens some cells have a large number of microvilli and well-developed in the perilluminous zone of the tonofilament. Characteristics peculiar to the secretory department of the sweat gland in the form of "mucous" and myoepithelial cells, as a rule, are absent. The "hyaline" membranes around and inside the tumor nodules under the cylindodromatous variant of spiradenoma consist of a multiplicated basal membrane.

[1], [2], [3], [4], [5], [6], [7], [8]