1/3. Clear cell hidradenoma: a mimic of metastatic clear cell tumors.Clear cell hidradenoma is a benign skin appendage tumor that may mimic conventional-type renal cell carcinoma. Histologically, clear cell hidradenoma contains small ductular lumens, focal apocrine and squamoid change, and a less prominent vascular pattern than renal cell carcinoma. Furthermore, immunohistochemical studies can aid in distinguishing the 2 tumors. Knowing the cytologic features of primary skin adnexal neoplasms helps distinguish them from cutaneous metastases, which are more commonly referred for fine-needle aspiration biopsy evaluation. Detailed clinical history, physical findings, and ancillary studies are essential for correct diagnosis and categorization of these tumors. We report the rare case of a patient with renal cell carcinoma who underwent excision of an axillary clear cell hidradenoma, which was clinically suggestive of cutaneous metastatic disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/3. Rounds in podiatric dermatology.Dr. Port presents six cases, which he refers to as "zebras," with clinical descriptions and discussions that typify his excellent teaching style. He also alludes to the fact that podiatrists need to be thorough in their history and physical evaluations. After a lesion has been treated appropriately and does not respond, additional investigation is in order. These cases are interesting to read but, most importantly, any one of these atypical patients could be seen in our offices tomorrow.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/3. sweat gland carcinoma with metastases to the skin: response to 5-fluorouracil chemotherapy.A 68-year-old white man presented to the inpatient service at Columbia-Presbyterian Hospital with a chief complaint of a progressively enlarging tumor of the right infraorbital region for many years and multiple, pink papulonodules on his head, neck, and trunk. A biopsy specimen of the right infraorbital and back lesions demonstrated an infiltrating adenocarcinoma with prominent signet ring cells, and small lumen formation. Results of an extensive work-up revealed bone marrow metastases and no evidence of a primary malignancy. We present a case of primary sweat gland carcinoma with metastases to the skin based upon history, clinical presentation, results of physical examination, histopathologic examination, immunohistochemical studies, and response to 5-fluorouracil chemotherapy. Due to the rarity of the tumor, the diagnosis is usually not made until the tumor(s) is invasive. An excellent response to systemic chemotherapy with 5-fluorouracil in metastatic sweat gland carcinoma was noted in this case.- - - - - - - - - - ranking = 20.483635674945keywords = physical examination, physical (Clic here for more details about this article) |