Malignant Appendage Tumours in Zaria

Abstract

Background: Malignant skin appendage tumours are rare and could be a source of diagnostic difficulty. They share many features in common and detailed morphological classification run into difficulties owing to the variety of tissue elements and patterns seen. This is a report of our experience of these tumours in Zaria, Nigeria.
Methods: A review of malignant appendage tumours diagnosed over a 16 year period (1990-2006). Histology slides stained routinely with Haematoxylin & Eosin were reviewed. Special stains were used where applicable for further characterization of the tumours. Patients' bio-data and clinical information were obtained from records.
Results: Six malignant appendage tumours were studied. There were 5 males and 1 female
aged 23 - 70 years. Mean age was 48.3 years. Clinical presentations varied from ulcerated
lesions to circumscribed swellings. One patient presented with a recurrent lesion. Differential
diagnoses included foreign body granuloma, keloid, fibroma, rhabdomyosarcoma and squamous cell carcinoma. The sites of occurrence were the axilla and trunk mainly. Histology of tissue biopsies showed nests of large oval to spindle to polygonal tumour cells forming occasional tubule containing eosinophilic globules and separated by fibrous septa. They were diagnosed malignant adnexeal tumour of Eccrine sweat gland origin.
Conclusion: Malignant appendage tumours showed a higher frequency in middle aged men
in this review. A good knowledge and understanding of the pathology, high index of suspicion and immunohistochemical studies should help in making diagnosis. Surgical intervention with wide margin excision should reduce recurrence rate. Further characterization of these tumours is desirable in our setting.

Keywords: Skin Appendage, Malignant, Eccrine Sweat gland

Sudanese Journal of Dermatology Vol. 5 (1) 2007: pp. 11-14