MALIGNANT NODULAR HIDRADENOMA

A 54-year-old male farmer was seen in May 1990 with a violaceous, exul cerated tumor, 2 x 1.5 cm in diameter, localized to the sternal area o f the chest (Fig. 1). The tumor had been present for 30 years, showing slow progressive growth; it was excised, but recurred 2 years before our initial evaluation. The tumor was again excised with a wide free m argin. The histopathologic study showed an ill-defined, epithelial neo formation, formed by lobules of clear polygonal cells at the deep derm is and subcutaneous tissue; there was a second group of smaller cells with a basaloid aspect, a few of them presenting slight atypia. The tu moral lobules were surrounded by a myxoid material with vascular proli feration. The epidermis was normal. The histopathologic report was of a malignant nodular hidradenoma (Figs 2 and 3). No evidence of lymph n ode or distant metastases was found. One year after the excision, the tumor recurred at the surgical site, and an axillary lymph node showed metastatic cells (Fig. 4). The lesion was excised for a third time an d the patient was lost to follow-up.