Accepted Manuscript

Hidradenocarcinoma of the scrotum

João Arthur Brunhara Alves Barbosa ,

Camila Tur de Arruda Ribeiro , Beni Grinblat ,
Ana Paula Garcia Cardoso , Eduardo Weltmann ,
Ebe Christie de Oliveira , Marco A. Watanabe Yorioka ,
Leonardo Lima Borges

PII: S0090-4295(19)30612-0
DOI: https://doi.org/10.1016/j.urology.2019.07.002
Reference: URL 21672

To appear in: Urology

Received date: 28 May 2019

Accepted date: 4 July 2019

Please cite this article as: João Arthur Brunhara Alves Barbosa , Camila Tur de Arruda Ribeiro ,
Beni Grinblat , Ana Paula Garcia Cardoso , Eduardo Weltmann , Ebe Christie de Oliveira ,
Marco A. Watanabe Yorioka , Leonardo Lima Borges , Hidradenocarcinoma of the scrotum, Urology
(2019), doi: https://doi.org/10.1016/j.urology.2019.07.002

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 ACCEPTED MANUSCRIPT

Hidradenocarcinoma of the scrotum

João Arthur Brunhara Alves Barbosa1,2, Camila Tur de Arruda Ribeiro3, Beni
Grinblat1, Ana Paula Garcia Cardoso1, Eduardo Weltmann1,2, Ebe Christie de
Oliveira1, Marco A. Watanabe Yorioka1,2, Leonardo Lima Borges1

1. Hospital Israelita Albert Einstein, São Paulo, Brazil

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2. University of São Paulo Medical School, São Paulo, Brazil

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3. Universidade Nove de Julho, São Paulo, Brazil

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Running title: Hidradenocarcinoma of the scrotum

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Keywords: scrotum, skin and soft tissue tumor, malignant tumor
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Acknowledgments: none
Source of funding: none
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Disclosures: none
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Correspondence to
Joao A B A Barbosa, MD
jbrunhara@gmail.com Phone +55 11 2661-6000 Fax + 55 11 2661 7208
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Hospital das Clínicas da Faculdade de Medicina da USP - Urologia

Av Dr Eneas Carvalho Aguiar, 255 – 7o andar (Urologia)
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São Paulo – Brazil

CEP 05403-000
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Abstract

Lesions of the skin and soft tissues of the penis and scrotum may be confusing in urological
practice, since rare differential diagnoses can be challenging to providers with limited
dermatological experience. Hidradenocarcinoma is one of such diagnoses, a rare and
aggressive malignant tumor originating from sweat glands.

A 61 year-old man presented with a nodule in the penoscrotal region which had appeared 1
year before consultation. He had no history of penile lesions, sexually transmitted diseases or
other complaints. Surgical resection revealed a hidradenocarcinoma of the scrotum infiltrating
subcutaneous tissue.

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Hidradenocarcinoma of the scrotum

Manuscript Text
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Hidradenocarcinoma is a rare and agressive malignant adnexal tumor
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originating from sweat glands, occuring more frequently in the head, neck and
extremities.[1] Presentation is often insidious with an asymptomatic slowly
growing skin nodule. Outcome is often poor, with up to 70% of local recurrence
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and up to 60% of lymph node metastasis.[2, 3] Differential diagnosis includes

benign and malignant tumors of skin and soft tissues,
including lipoma, lymphangioma, squamous cell carcinoma, and melanoma.[4]
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We present the case of a 61 year-old man presenting with a skin lesion in the
penoscrotal region which had started 1 year before consultation, starting to
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present faster growth in the previous 2 months.(Figure 1) He had no history of

sexually transmitted diseases, urethral discharge, previous penile lesions,
lymph node enlargement or any other complaints. The patient underwent
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surgical resection of the lesion with extended surgical margins of 2 mm.(Figure

2) Pathology report revealed a Hidradenocarcinoma of the scrotum infiltrating
subcutaneous tissue.(Figure 3) Abdominal and pelvic CT scan revealed no
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lesions and no lymph node enlargement. Following surgery, the patient

underwent 30 sessions of electron beam therapy comprising a total of 60 Gy
applied to a circumferencial area of 3 centimeters from the site of ressection.
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References

1.Gauerke S, Driscoll JJ. Hidradenocarcinomas: A Brief Review and Future

Directions. Archives of Pathology and Laboratory Medicine. May 2010;
134(5):781-5.

2. Avraham JB, Villines D, Maker VK, August C, Maker AV. Survival after
resection of cutaneous adnexal carcionmas with eccrine differentiation. J Surg

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Oncol. 2013;108:57-62.

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3. Shu K, Xiao Q, Büchele F, Zhang S, Jiang W, Lei T. Diagnosis and treatment
of clear cell hidradenocarcinoma of the scalp. J Huazhong Univ Sci Technol.

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2012;32:931-6.

4. Soni A, Bansal N, Kaushal V, Chauhan AK. Current management approach

to hidradenocarcinoma: a comprehensive review of the

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literature. Ecancermedicalscience. 2015;9:517.
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Figures

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Figure 1. Nodule located in the penoscrotal region, which had appeared 1 year
before consultation. The nodule was hard in consistency and was mobile to
palpation.
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Figure 2. Site of resection of the tumor with exposure of the corpora cavernosa
and corpus spongiosum.
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Figure 3. Histological aspects of a hidradenocarcinoma of the scrotum. A. 10x

magnification with hematoxylin and eosin staining (HE) reveals a cystic-solid
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tumor with irregular borders originating in the dermis and extending through the
subcutaneous tissue. B. 150x magnification with HE showing clear cells and
squamoid cells. C. 150x magnification with Periodic acid-Schiff diastase stain
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revealing areas of ductal differentiation. D. 150x magnification with HE showing

infiltrative borders in the profound margin of the lesion.