A Rare Case Of Malignant Skin Adnexal Tumor Of Eccrine Origin

Abstract

Malignant adnexal tumors of the skin are rare neoplasms that arise from eccrine, apocrine, sebaceous, or follicular units and account for less than 1% of all skin malignancies. They often mimic more common skin cancers both clinically and histologically, posing diagnostic challenges. Here, we report a case of a 73-year-old female with a recurrent scalp swelling, eventually diagnosed as a malignant adnexal tumor of  eccrine origin. The patient underwent wide local excision with free flap reconstruction. Histopathological examination confirmed complete tumor excision with clear margins. This case highlights the importance of considering adnexal carcinoma in the differential diagnosis of scalp lesions and underscores the critical role of histopathology and surgical management in such cases.

Case presentation

A 73-year-old woman presented with a recurrent, slowly progressive scalp swelling over the occipital region for two years, associated with intermittent pricking pain. She had undergone a previous excision two years earlier, but no histopathological records were available. CT  showed mixed density heterogenous lesion with surface calcification in the scalp. Wide local excision was done and histopathological examination revealed a malignant adnexal tumor, of eccrine origin. The post-excisional defect was managed with a free thoracodorsal artery perforator flap. The patient had an uneventful recovery with no immediate postoperative complications