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Annales de Dermatologie et de Vénéréologie
Volume 144, n° 3
pages 203-207 (mars 2017)
Doi : 10.1016/j.annder.2016.09.038
Received : 30 January 2016 ;  accepted : 2 September 2016
Transformation maligne d’un spiradénome eccrine
Malignant transformation of an eccrine spiradenoma
 

J. Jacquemus a, , S. Dalle b, M. Faure c, B. Chouvet d, O. Beatrix e, B. Balme a
a Service de pathologie, centre hospitalier Lyon sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France 
b Service de dermatologie, centre hospitalier Lyon sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France 
c Service de dermatologie, hôpital Édouard-Herriot, 5, place d’Arsonval, 69003 Lyon, France 
d Service de pathologie, hôpital Édouard-Herriot, 5, place d’Arsonval, 69003 Lyon, France 
e Service de chirurgie, centre hospitalier Lyon sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France 

Auteur correspondant.
Résumé
Introduction

Le spiradénome eccrine malin est une tumeur rare et agressive développée aux dépens de l’épithélium des glandes eccrines cutanées ; il survient en général sur un spiradénome eccrine bénin, plus rarement de novo. Nous en présentons un nouveau cas.

Observation

Une femme de 62 ans consultait en raison de la brutale augmentation de volume d’une masse tumorale de l’avant-bras droit présente depuis l’enfance. Une tomodensitométrie thoraco-abdomino-pelvienne ne montrait pas de lésion suspecte. Une biopsie cutanée au punch de 5mm confirmait la nature carcinomateuse de cette lésion, mais sans pouvoir en préciser le caractère primitif ou secondaire en l’absence de connexion avec l’épiderme. L’examen histologique de la pièce d’exérèse trouvait une prolifération carcinomateuse indifférenciée adjacente à des nodules de spiradénome eccrine bénin. Le marquage par l’anticorps Ki67 mettait en évidence un indice de prolifération de 5 % au niveau de la composante spiradénome eccrine et de 80 % au niveau du carcinome. Le diagnostic retenu était celui de carcinome indifférencié correspondant à la transformation maligne d’un spiradénome eccrine.

Discussion

Le spiradénome eccrine malin est rare et peu décrit dans la littérature, ce qui peut rendre son diagnostic difficile.

The full text of this article is available in PDF format.
Summary
Introduction

Malignant eccrine spiradenoma is a rare and aggressive tumor, developed on the epithelium of eccrine sweat glands. Typically, it occurs after malignant transformation of benign eccrine spiradenoma, but sometimes it happens de novo.

Observation

We report a case of malignant eccrine spiradenoma in a 62-year-old woman. The patient presented a rapid increase in size of a long-standing tumoral lesion of her forearm. There was no secondary lesion on the chest, abdomen or pelvis at the CT-scanner. Cutaneous biopsy of the lesion was performed and showed a carcinoma with no contact with epidermis. On this biopsy, we could not affirm if the tumor was a metastatic process or a primary tumor of the skin. Histologic examination of the surgical removal of the tumor showed an undifferentiated carcinoma with adjacent nodules of eccrine spiradenoma. Immunohistochemical assessment of Ki67 expression showed a weak expression (5%) in the benign spiradenoma nodules and a high rate expression (80%) in the malignant neoplasm. The final diagnosis was an undifferentiated carcinoma arising from preexisting benign spiradenoma.

Discussion

Malignant eccrine spiradenoma is not frequent and is rarely described in the international literature that may lead to diagnostic difficulties.

The full text of this article is available in PDF format.

Mots clés : Spiradénocarcinome, Spiradénome eccrine, Transformation maligne, Carcinome sudoral

Keywords : Spiradenocarcinoma, Eccrine spiradenoma, Malignant transformation, Sudoral carcinoma




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