We describe a case of malignant eccrine acrospiroma in an 80-year-old man, and we review the literature on this tumor, with emphasis on the differential diagnosis.
A malignant eccrine acrospiroma (MEA) is a rare cutaneous tumor.
The diagnosis of MEA in this case was established by the presence of both a benign and malignant neoplasm in the same tumor--that is, there was a recognizable benign eccrine acrospiroma adjacent to the malignant tumor cells (figure 1).
The tumor in our patient would have been classified as an eccrine adenocarcinoma NOS if the benign eccrine acrospiroma component had not been present.
An eccrine acrospiroma is a deep dermal or subcutaneous nodular neoplasm that is sometimes connected to the epidermis.
Eccrine spiradenoma is made up of small, primitive-looking basaloid cells that are different from the squamoid cells seen in eccrine acrospiroma.
2-4) Clini cally, both malignant and benign eccrine acrospiromas are painless, solitary, and firm dermal masses whose color varies (flesh-toned, red, blue, or brown).
Reports in the literature consistently emphasize the slow growth rate of both malignant and benign eccrine acrospiromas.
The clinical similarity of malignant and benign eccrine acrospiromas to other cutaneous lesions (e.
2,3,14) Similarly, there are cases of eccrine acrospiromas with atypical nuclear changes and cellular pleomorphism that are clinically benign.