Management of a hidradenoma with Mohs micrographic surgery

Nancy S. House, Pennsylvania State University
Klaus F. Helm, Pennsylvania State University
Mary E. Maloney, University of Massachusetts Medical School

At the time of publication, Mary E. Maloney was not yet affiliated with the University of Massachusetts Medical School.

Abstract

BACKGROUND: Hidradenomas are adnexal tumors that may grow to be very large and frequently recur after excision. Malignant transformation and metastatic spread can occur and histologic distinction of benign from malignant hidradenomas can be very difficult. Some tumors with bland histology have demonstrated aggressive behavior.

OBJECTIVE: To decide the benefits of management with Mohs micrographic surgery of large hidradenomas.

METHODS: The literature was reviewed, including both the clinical course of the tumor and histologic features. The case of our report was interpreted in light of the review.

RESULTS: Three stages of Mohs surgery were required for complete removal of the hidradenoma. The patient remains free of recurrence.

CONCLUSION: This report highlights the difficulties in distinguishing benign from malignant hidradenomas and emphasizes the benefits of Mohs surgery for large or recurrent tumors.