Clear cell hidradenoma (nodular hidradenoma)

Discussion:

Nodular hidradenoma may also be referred to as clear cell hidradenoma (when there is a prominent clear cell component) or eccrine acrospiroma. A lesion with numerous aliases, it has also been referred to as clear cell myoepithelioma, solid-cystic hidradenoma and eccrine sweat gland adenoma of clear cell type. 

Nodular hidradenoma is a benign dermal-based skin appendageal neoplasm most commonly seen around axillary and scalp regions. There is no connection with the overlying epidermis. 

Lesions display a nodular, lobulated, cystic and solid growth pattern and are composed of an admixture of both eosinophilic and clear cells.  Trichilemmal-like keratinization is common, and focal sebaceous differentiation may also be seen. When clear cells predominate, lesions may be referred to as clear cell hidradenoma. 

Tumors usually behave in a benign fashion, but may rarely behave aggressively, and may recur if inadequately excised. 

When exhibiting striking clear cell differentiation, the possibility of a metastatic clear cell tumor may need to be considered. 

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