A malignant eccrine spiradenoma of the scalp

Malignant eccrine spiradenoma (MES) is an extremely rare but aggressive tumour, resulting in high mortality. We report the first case in the UK of metastatic MES on the scalp of a 37-year-old man who initially presented with a raised nodular mass which had grown rapidly over a few months. Excision b...

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Bibliographic Details
Published in:BMJ case reports 2014-05, Vol.2014, p.bcr2013202524
Main Authors: Chow, Whitney, Griffiths, Mat
Format: Article
Language:English
Subjects:
Adenoma, Sweat Gland - diagnosis
Adenoma, Sweat Gland - pathology
Adenoma, Sweat Gland - surgery
Adult
Biopsy
Biopsy, Needle
Chemotherapy
Eccrine Glands - pathology
Family medical history
Follow-Up Studies
Gangrene
Histology
Humans
Immunohistochemistry
Lymphatic system
Male
Medical imaging
Metastasis
Mortality
Neoplasm Invasiveness - pathology
Neoplasm Staging
Patients
Rare Diseases
Reminder of Important Clinical Lesson
Scalp - pathology
Scalp - surgery
Skin cancer
Skin Neoplasms - pathology
Skin Neoplasms - surgery
Surgery
Sweat Gland Neoplasms - diagnosis
Sweat Gland Neoplasms - pathology
Sweat Gland Neoplasms - surgery
Tomography, X-Ray Computed - methods
Treatment Outcome
Tumors
United Kingdom
White
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Summary:Malignant eccrine spiradenoma (MES) is an extremely rare but aggressive tumour, resulting in high mortality. We report the first case in the UK of metastatic MES on the scalp of a 37-year-old man who initially presented with a raised nodular mass which had grown rapidly over a few months. Excision biopsy of the lesion was performed and histology confirmed MES with evidence of cytological atypia and necrosis. A further wide local excision of the lesion with a 1 cm surgical margin was performed and full clearance was achieved. At 10-month follow-up another similar lesion had developed close to the previously excised area. A CT scan demonstrated metastatic lesions in the lungs, liver and pelvis, and subsequently chemotherapy was initiated. Although MES is uncommon, it has a high propensity to metastasise, therefore prompt identification, treatment and close follow-up of these tumours is essential.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-202524