From the Research
Hidradenoma is a benign tumor that originates from sweat glands, typically presenting as a slow-growing cystic nodule on the scalp or trunk, and is best managed with complete surgical excision with clear margins to prevent recurrence, as indicated by the most recent study 1.
Definition and Characteristics
Hidradenoma is a rare, benign tumor that develops from sweat glands in the skin, and it can appear as a solitary, firm nodule that ranges from 0.5 to 2 cm in size, with varying colors such as skin-colored, pink, or bluish. These tumors most commonly occur on the head, neck, and extremities, though they can develop anywhere on the body.
Classification and Symptoms
Hidradenomas are classified into clear cell and nodular types, with clear cell hidradenomas being more common in women and nodular hidradenomas having no gender preference. While generally asymptomatic, some patients may experience pain, tenderness, or ulceration if the tumor grows larger.
Treatment and Prognosis
The recommended treatment is complete surgical excision with clear margins to prevent recurrence, as these tumors can occasionally recur if incompletely removed, as noted in a study from 2. Although hidradenomas are typically benign, there are rare cases of malignant transformation, which is why proper diagnosis through biopsy and complete removal is important, as highlighted in a case report 3. Regular follow-up after removal is advised to monitor for any recurrence.
Diagnostic Considerations
It's essential to distinguish hidradenomas from other tumors, such as digital papillary adenocarcinoma, particularly when they occur on acral sites, as discussed in a study published in 2. Immunohistochemistry can be helpful in making this distinction, with hidradenomas typically expressing AE1/3, CK5/6, p40, and p63 strongly and diffusely.
Management Approach
In cases of large or recurrent hidradenomas, Mohs micrographic surgery may be beneficial, as it allows for complete removal of the tumor while preserving surrounding tissue, as reported in a study from 4. However, the most recent and highest quality study 1 supports the use of complete surgical excision with clear margins as the primary treatment approach.