Handchir Mikrochir Plast Chir 2013; 45(05): 287-292
DOI: 10.1055/s-0033-1357130
Fallbericht
© Georg Thieme Verlag KG Stuttgart · New York

Das Hidradenokarzinom des Handgelenkes – ein extrem seltener maligner Tumor: Falldarstellung und Literaturübersicht

The Hidradenocarcinoma of the Wrist – an Extremely Rare Malignant Carcinoma: Case Presentation and Literature Review
A. Arsalan-Werner
1   Abteilung für Plastische, Hand- und Rekonstruktive Chirurgie, -Hand-Trauma-Center-, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt
,
T. Mentzel
2   Gemeinschaftspraxis, Dermatopathologie Friedrichshafen, Friedrichshafen
,
B. Kempf
3   Institut für Pathologie und Zytodiagnostik Main-Taunus, Standort Bad Homburg, Bad Homburg
,
M. Sauerbier
1   Abteilung für Plastische, Hand- und Rekonstruktive Chirurgie, -Hand-Trauma-Center-, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt
› Author Affiliations
Further Information

Publication History

eingereicht 08 September 2013

akzeptiert 11 September 2013

Publication Date:
02 October 2013 (online)

Zusammenfassung

Das Hidradenokarzinom ist ein seltener, aber hochmaligner Tumor, der zu den ekkrinen Schweißdrüsentumoren zählt. Aufgrund seines lokal invasiven Wachstums mit häufiger Metas­tasierung sollte er insbesondere bei unklarem intraoperativem Befund differenzialdiagnostisch in Erwägung gezogen werden. Wir beschreiben den Fall einer 73-jährigen Patientin mit Hidradenokarzinom des Handgelenkes mit einer Nachbeobachtungszeit von über 4 Jahren. Die Behandlung erfolgt analog zu Sarkomen: Nach Inzisionsbiopsie mit Referenzpathologie und Staging erfolgt in einem zweiten Schritt die radikale Resektion und plastisch-chirurgische Deckung. Anschließend ist eine engmaschige Nachbetreuung zur frühen Detektion eines Rezidivs notwendig.

Abstract

Hidradenocarcinomas are rare, yet highly malignant tumors of eccrine sweat gland origin. Due to its locally aggressive growth and likelihood for metastasis it should be considered as a differential diagnosis especially in case of suspicious intraoperative findings. We report the case of a 73-year-old female patient presenting with a hidradenocarcinoma of the wrist. Treatment of hidradenocarcinomas is similar to the treatment of sarcomas: The first step is an incisional biopsy and obtaining an expert second opinion on the histopathological diagnosis as well as staging. The second step is a clear margin resection of the tumor and the plastic-surgical reconstruction. A long-term follow-up is mandatory to detect potential recurrence or metastasis.

 
  • Literatur

  • 1 Keasbey LE, Hadley GG. Clearcell hidradenoma; report of three cases with widespread metastases. Cancer 1954; 7: 934-952
  • 2 Nazarian RM, Kapur P, Rakheja D et al. Atypical and malignant hidradenomas: a histological and immunohistochemical study. Mod Pathol 2009; 22: 600-610
  • 3 Gortler I, Koppl H, Stark GB et al. Metastatic malignant acrospiroma of the hand. Eur J Surg Oncol 2001; 27: 431-435
  • 4 Gauerke S, Driscoll JJ. Hidradenocarcinomas: a brief review and future directions. Arch Pathol Lab Med 2010; 134: 781-785
  • 5 Reyes CV. Clear cell hidradenocarcinoma developing in pacemaker pocket. Pacing Clin Electrophysiol 2008; 31: 1513-1515
  • 6 Chang CH, Chang KP, Huang SH et al. Hidradenocarcinoma of the fingertip: a case report and literature review. Dermatol Surg 2011; 37: 704-708
  • 7 Amel T, Olfa G, Faten H et al. Metastatic hidradenocarcinoma: Surgery and chemotherapy. N Am J Med Sci 2009; 1: 372-374
  • 8 Ko CJ, Cochran AJ, Eng W et al. Hidradenocarcinoma: a histological and immunohistochemical study. J Cutan Pathol 2006; 33: 726-730
  • 9 Biernat W, Peraud A, Wozniak L et al. p53 mutations in sweat gland carcinomas. Int J Cancer 1998; 76: 317-320
  • 10 Megerle K, Sauerbier M. Reconstructive treatment of soft tissue sarcoma of the upper extremity. J Hand Surg Am 2011; 36: 1241-1247
  • 11 Megerle K, Sauerbier M, Germann G. The evolution of the pedicled radial forearm flap. Hand 2010; 5: 37-42
  • 12 Rubenzik M, Keller M, Humphreys T. Mohs micrographic surgery for hidradenocarcinoma on a rhinophymatous nose: a histologic conundrum. Dermatol Surg 2010; 36: 2075-2078
  • 13 Yavel R, Hinshaw M, Rao V et al. Hidradenomas and a hidradenocarcinoma of the scalp managed using Mohs micrographic surgery and a multidisciplinary approach: case reports and review of the literature. Dermatol Surg 2009; 35: 273-281
  • 14 Vetter M, Germann G, Bickert B et al. Current strategies for sarcoma reconstruction at the forearm and hand. J Reconstr Microsurg 2010; 26: 455-460
  • 15 Rüttgen R. Schweißdrüsenkarzinome der Haut. Hautarzt 2008;
  • 16 Bogner PN, Fullen DR, Lowe L et al. Lymphatic mapping and sentinel lymph node biopsy in the detection of early metastasis from sweat gland carcinoma. Cancer 2003; 97: 2285-2289
  • 17 Harari PM, Shimm DS, Bangert JL et al. The role of radiotherapy in the treatment of malignant sweat gland neoplasms. Cancer 1990; 65: 1737-1740
  • 18 Lalya I, Hadadi K, Tazi el M et al. Radiotherapy on hidradenocarcinoma. N Am J Med Sci 2011; 3: 43-45
  • 19 Long WP, Dupin C, Levine EA. Recurrent malignant acrospiroma. Treatment by chest wall excision. Dermatol Surg 1998; 24: 908-912 discussion 911-902
  • 20 Surasi DS, Lam S, Subramaniam RM. F-18 FDG PET/CT imaging of a hidradenocarcinoma of head and neck. Clin Nucl Med 2011; 36: 945-947
  • 21 Lerner A, Beckford A, Ugent S et al. Complete response of metastatic malignant hidradenocarcinoma to capecitabine treatment. Arch Dermatol 2011; 147: 998-999
  • 22 Jouary T, Kaiafa A, Lipinski P et al. Metastatic hidradenocarcinoma: efficacy of capecitabine. Arch Dermatol 2006; 142: 1366-1367
  • 23 Nash JW, Barrett TL, Kies M et al. Metastatic hidradenocarcinoma with demonstration of Her-2/neu gene amplification by fluorescence in situ hybridization: potential treatment implications. J Cutan Pathol 2007; 34: 49-54
  • 24 Kazakov DV, Ivan D, Kutzner H et al. Cutaneous hidradenocarcinoma: a clinicopathological, immunohistochemical, and molecular biologic study of 14 cases, including Her2/neu gene expression/amplification, TP53 gene mutation analysis, and t(11;19) translocation. Am J Dermatopathol 2009; 31: 236-247
  • 25 Battistella M, Mateus C, Lassau N et al. Sunitinib efficacy in the treatment of metastatic skin adnexal carcinomas: report of two patients with hidradenocarcinoma and trichoblastic carcinoma. J Eur Acad Dermatol Venereol 2010; 24: 199-203