JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Special Issue "Pathology", March, 2023

Pages: 1145-1145
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Clinicopathologic analysis of 169 cases of cutaneous adnexal tumors: a retrospective study.

Author: S. Moqran, L. Tahiri Elousrouti, S. Elloudi, Fz. Elmernissi, N. Elouatassi, Mn. Elalami, L. Chbani, H. El-Fatemi, N. Hammas

Category: JMSR Pathology

Abstract:

Background and objectives: Adnexal tumors (ATs) are a heterogeneous entity of primary skin tumors, rarely malignant. Their diagnosis represents a real challenge due to their polymorphism and the locoregional aggressiveness of adnexal carcinomas with their metastatic potential. This study aims to elucidate the morphological and epidemiological characteristics of these tumors through a series of Moroccan patients and to compare them with other series in the literature.

Methods: A retrospective study was conducted over a period of 10 years (2013–2022), including all adnexal tumors of skin diagnosed in the Department of Pathology, University hospital Hassan II of Fez, Morocco. The histological study was performed on formalin-fixed and paraffin-embedded tissue sections. The diagnosis was essentially morphological. Special staining or immunohistochemical complement was rarely used.

Results: Total number of cases that was diagnosed as ATs were 169. There were 135 benign tumors (80%) and 34 malignant tumors (20%). A female predominance was noted with a sex ratio M/F of 0.72. The mean age was 49 yr (5yr-90yr). Most of the cases were in the age group between the 4th and 5th decades (51–60 yr (32/169 cases)). The head and neck are the most often affected areas (74.6%). About 44% of the tumors displayed sweat gland differentiation, 44% hair follicle differentiation, and 12% of the tumors were sebaceous gland tumors. tumors with follicular differentiation were predominant among adnexal carcinomas (58%). Pilomatricoma (16.6%) was the most prevalent tumor of all ATs, followed by chondroid syringoma (13%). Sebaceous Carcinoma (5.6%) was the most common malignant adnexal tumor. The detailed clinicopathological data are shown in the Table.

All of our patients have benefited from a surgical procedure for the treatment of cutaneous adnexal carcinomas. Only 4 patients have been recommended for adjuvant radiotherapy.Following up with our patients allowed us to identify a recurrence in one case in the form of lymph node metastasis and a parotid metastasis in another.

Conclusion: Our findings generally concur with those found in the literature, With the exception of the frequency of carcinomas with follicular origin rather than those with sweat gland origin in other series.

Keywords: Benign, malignant, histopathology, Cutaneous adnexal tumors

Full Text:

Background and objectives: Adnexal tumors (ATs) are a heterogeneous entity of primary skin tumors, rarely malignant. Their diagnosis represents a real challenge due to their polymorphism and the locoregional aggressiveness of adnexal carcinomas with their metastatic potential. This study aims to elucidate the morphological and epidemiological characteristics of these tumors through a series of Moroccan patients and to compare them with other series in the literature.

Methods: A retrospective study was conducted over a period of 10 years (2013–2022), including all adnexal tumors of skin diagnosed in the Department of Pathology, University hospital Hassan II of Fez, Morocco. The histological study was performed on formalin-fixed and paraffin-embedded tissue sections. The diagnosis was essentially morphological. Special staining or immunohistochemical complement was rarely used.

Results: Total number of cases that was diagnosed as ATs were 169. There were 135 benign tumors (80%) and 34 malignant tumors (20%). A female predominance was noted with a sex ratio M/F of 0.72. The mean age was 49 yr (5yr-90yr). Most of the cases were in the age group between the 4th and 5th decades (51–60 yr (32/169 cases)). The head and neck are the most often affected areas (74.6%). About 44% of the tumors displayed sweat gland differentiation, 44% hair follicle differentiation, and 12% of the tumors were sebaceous gland tumors. tumors with follicular differentiation were predominant among adnexal carcinomas (58%). Pilomatricoma (16.6%) was the most prevalent tumor of all ATs, followed by chondroid syringoma (13%). Sebaceous Carcinoma (5.6%) was the most common malignant adnexal tumor. The detailed clinicopathological data are shown in the Table.

All of our patients have benefited from a surgical procedure for the treatment of cutaneous adnexal carcinomas. Only 4 patients have been recommended for adjuvant radiotherapy.Following up with our patients allowed us to identify a recurrence in one case in the form of lymph node metastasis and a parotid metastasis in another.

Conclusion: Our findings generally concur with those found in the literature, With the exception of the frequency of carcinomas with follicular origin rather than those with sweat gland origin in other series.

Key words: Benign, malignant, histopathology, Cutaneous adnexal tumors

		mean age	Sex ratio (M/F)	Localisation
Sweat gland differentiation (44%)	Benign tumors: Chondroïd Syringoma (13%)	46 years 34 years	1.75	Head and neck (95%)
	Hidrocystoma (8.9%)	42 years	1.5	Head and neck (73%)
	Syringocystadénoma papillifère (4.1%)	43 years	0.4	Head and neck (100%)
	Hidradénome nodulaire (4%)	51 years	4 women	Extremities (75%)
	Syringoma (3.6%)	47 years	0.5	Head and neck (83%)
	Poroma (2.4%)	52 years	0.33	Head and neck (50%) Extremities (50%)
	Cylindroma (1.8%)	46 years	3 women	Head and neck (100%)
	Hidradenoma Papilliferum (1.8%)	43 years	3 women	Genital tract (100%)
	Hidradenoma (1.8%)	57 years	1.5	Genital tract (67%)
	Spiradenoma (1.2%)	33 years	1	Head and neck (100%)
	Syringofibroadenoma (0.6%)	65 years	1 woman	Extremities
	Malignant tumors :	66 years	1	Head and neck (50%) Extremities (50%)
	Micrcystic adnexal carcinoma (0.6%)	69 years	1 man	Head and neck
	Syringoid eccrine carcinoma (0.6%)	65 years	1 woman	Head and neck
Hair follicle differentiation (44%)	Benign tumors: Pilomatricoma (16.6%)	24 years	0.64	Extremities (72%)
	Trichoblastoma (11.8%)	60 years	0.81	Head and neck (90%)
	Trichilemmoma (1.8%)	41 years	2	Head and neck (67%)
	Trichofolliculoma (1.2%)	49 years	1	Head and neck (100%)
	poroma (0.6%)	21 years	1 man	Head and neck
	Malignant tumors : Proliferating trichilemmal tumor (5.3%)	54 years	0.12	Head and neck (89%)
	Trichilemmal carcinoma (3.6%)	48 years	0.5	Head and neck (67%)
	Trichoblastic Carcinoma (1.8%)	61 years	1	Head and neck (100%)
	Pilomatrix carcinoma 0.6%)	75 years	1 woman	Head and neck
Sebaceous gland differentiation (12%)	Benign tumors: Sebaceous Hyperplasia (3.6%)	76 years	3	Head and neck (100%)
	Sebaceous Adenoma (2.4%)	53 years	1	Head and neck (100%)
	Malignant tumors : Sebaceous Carcinoma (5.9%)	67 years	0.66	Head and neck (90%)
Total : 169 patients	Tumeur bénigne : 135 (79.9%) Tumeur maligne : 34 (20.1%)	46 years 63 years	0.77 0.54	Head and neck (66%) Head and neck (85%)

References:

1. Battistella, Maxime, et al. Impact of expert pathology review in skin adnexal carcinoma diagnosis: Analysis of 2573 patients from the french caraderm network. European Journal of Cancer, 2022, 163: 211-221.?
2. El ochi, Mohamed Réda, et al. Les tumeurs annexielles cutanées: étude anatomopathologique à propos de 96 cas. The Pan African Medical Journal, 2015, 20.?
3. OMAR, A. M. R. M.; NATAG, Osman. Four years retrospective study of skin adnexal tumors: Histomorphology and special stain study. Int J Med Sci Public Health, 2020, 9: 273-9.?
4. KOUKI, Chaima, et al. Les tumeurs annexielles: étude monocentrique de 248 cas. Annales de Dermatologie et de Vénéréologie-FMC, 2021, 1.8: A288-A289.?
5. KAUR, Kanwalpreet, et al. Histopathological analysis of skin adnexal tumors: A three year study of 110 cases at a tertiary care center. Indian journal of dermatology, 2017, 62.4: 400.?