頂泌腺瘤是相當罕見的皮膚附屬器官腫瘤,好發於腋下、面頰及乳房。根據不同的組織型態,有各種類似的診斷如管狀頂泌腺瘤、管狀及乳突狀汗腺瘤、頂泌汗腺瘤和頂泌囊狀腺瘤等等;其中出現外陰和肛門周圍的肛門生殖器類乳腺體腺瘤更是非常少見的一種變異型。本文報告一位43歲的男性病例,在肛門周圍長出一個皮膚腫瘤;肉眼及顯微鏡下為一界限分明的真皮腫瘤,除了有管狀及乳突狀的生長特徵外,也有非常明顯的囊狀構造,並出現頂泌活性;所有的病理組織型態符合囊狀管狀頂泌腺瘤或囊狀頂泌腺瘤之診斷;同時加上其特殊的解剖部位,肛門生殖器類乳腺體腺瘤是適切的診斷。此病例報告呈現了肛門生殖器類乳腺體病變的複雜性;完全切除病灶可以避免日後的復發或罕見的惡性轉變。
Apocrine adenomas are rare skin appendage tumors mostly located in the axilla, cheek, and breast. Variable synonyms, including tubular apocrine adenomas, tubulopapillary hidradenomas, apocrine hidradenomas, and apocrine cystadenomas, have been used for their specific histomorphology. A relatively unusual variant found in the vulvar and perianal areas was labeled an adenoma of the anogenital mammary-like glands (MLGs). Herein, we report a 43-year-old man who presented with a dermal tumor in the perianal region. Macroscopically and microscopically, it was a well-circumscribed tumor in the dermis. In addition to the tubular and papillary features, there were copious cystic components. Decapitation activity was present. The overall histopathological morphology was consistent with a cystic tubular apocrine adenoma or apocrine cystadenoma. Together with the specific anatomical location, a diagnosis of an adenoma of anogenital MLGs was appropriate. This case report illustrates the complexity of lesions derived from MLGs. Complete excision of these lesions is recommended to prevent future recurrence and rare malignant transformation.
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