What is Spiradenoma?
Spiradenomas are harmless skin growths that originate from sweat glands. The growths are quite well-formed or “well-differentiated” in medical terms, and they’re not harmful. People aged between 15 to 35 years are more likely to experience such growths. Spiradenomas usually look like small, single bumps that can grow to several centimeters. They often exhibit colors like blue, gray, or purple. Notably, they can be very painful.
A spiradenoma typically shows up on the head, neck, and trunk, but there have been cases where they appear in other areas, such as the breast. There are also different types of spiradenomas that appear in unique patterns or shapes. Also, it’s possible for a person to have spiradenomas at the same time as other types of skin growths, such as cylindromas, trichoepitheliomas, or trichoblastomas.
Conditions where a person has multiple spiradenomas, cylindromas, and trichoepitheliomas are often seen in patients with a condition called Brooke-Spiegler. Brooke-Spiegler is a rare genetic disorder that causes skin tumors to form in hair follicles.
What Causes Spiradenoma?
Spiradenomas, a type of skin tumor, are believed to be caused by a problem in a gene that usually works to prevent tumors. This faulty gene, known as the CYLD gene, is found on chromosome 16 and has been found in a condition known as Brooke-Spiegler syndrome, which results in multiple spiradenomas.
The exact cause of isolated spiradenomas is still unclear. Originally, it was believed that they started in a type of sweat gland known as the eccrine gland. However, new studies indicate that spiradenomas could originate from a different type of sweat gland called the apocrine gland, or from the folliculosebaceous unit – the part of the skin that contains the hair follicle and oil glands.
As for malignant spiradenomas, or spiradenomas that can become cancerous, the exact cause is also unknown. It’s been noticed that the tumor suppressor gene p53 tends to be more active in these cases, but it’s still unclear what role this plays in spiradenomas becoming malignant.
Risk Factors and Frequency for Spiradenoma
Spiradenomas are typically benign, or non-cancerous, and often appear in individuals between the ages of 15 and 35. However, cases have been seen in infants also. Spiradenomas affect all races and genders equally. There have only been around 15 cases of specific types of spiradenomas, such as linear, zosteriform, nevoid, blaschkoid, or multiple spiradenomas, reported so far. While benign spiradenomas are rather unusual, malignant or cancerous spiradenomas are even more uncommon. The latter typically shows up in individuals over the age of 50, with the average age being 59.
Signs and Symptoms of Spiradenoma
Spiradenomas are bumps that can appear beneath the skin anywhere on your body, but they are usually seen on the head, neck, and midsection. They are less likely to appear on arms and legs. Some are reported on the ears, eyelids, and around the nails. On examination, these bumps are typically small in size but could grow into several centimeters wide. They can have a blue, gray, or purple color. While spiradenomas can cause significant discomfort, many don’t cause any discomfort at all. Usually, you find only one of these bumps, but they can appear in a line or group. When many spiradenomas appear along with other skin conditions like cylindromas and trichoblastomas, it might suggest a condition known as Brooke-Spiegler syndrome.
Other conditions can resemble spiradenomas, including cysts, dermatofibroma (another type of skin nodule), leiomyomas (smooth muscle tumors), poromas (skin tumors), and basal cell carcinoma (a type of skin cancer).
Although very rare, spiradenomas can also appear in infants, making up less than 1% of all reported spiradenoma cases. In infants, these nodules tend to be more on the skin’s surface than in adults
It’s important to note that spiradenomas can turn bad. When a spiradenoma that’s been present for a long time suddenly begins to grow quickly, it could be a sign of malignancy. Malignant spiradenomas usually cause sores, prefer to appear on the trunk and extremities, and may change color. They can also spread to other body parts such as lymph nodes, lungs, brain, or liver.
Testing for Spiradenoma
If the doctor suspects any skin abnormalities, they might remove or “excise” the abnormal part for further examination under the microscope, known as a histopathologic exam. In this examination, spiradenomas, a type of benign skin tumor, show one or more large, clearly outlined dark-blue nodules in the second layer of the skin, which is known as the dermis.
Two types of cells can be seen in these nodules. One type is small, dark cells that resemble the base layer of the skin and have densely packed (‘hyperchromatic’) nuclei, the control center of the cell. The other is larger, pale cells with oval-shaped nuclei.
If the spiradenoma turns malignant or cancerous, it will show increased cell division rates (‘mitotic rates’), cell death (‘necrosis’), irregular cell shapes (‘nuclear atypia’), variation in shape and size (‘pleomorphism’), increased staining(‘hyperchromasia’), and the loss of the typical growth patterns and dual cell population.
Additional imaging studies, such as an MRI, CT scan, or ultrasound, can help determine if the cancer has spread to other parts of the body, a process known as metastasis. This is crucial in the identification and treatment of malignant spiradenomas.
Treatment Options for Spiradenoma
Spiradenoma is a type of harmless growth that develops in the skin, specifically in the sweat glands – a condition referred to as a benign adnexal neoplasm. Most of the time, these growths do not return after removal and are considered quite safe. However, in some rare cases, especially in individuals over 50 years old, these harmless growths can turn into cancerous tumors over time. This transformation is known as malignant spiradenocarcinoma, and it carries a risk of spreading to other parts of the body, or “metastasizing,” in about half of the cases.
Due to this potential for malignancy, it is generally recommended to remove spiradenomas through a conservative surgical procedure. When a patient has multiple spiradenomas, the doctor might use a carbon dioxide laser to reduce the size of the growths after surgically removing the major part of them.
Malignant spiradenomas are typically more dangerous, having a high possibility of spreading to other parts of the body and causing death. Therefore, in addition to surgical removal, radiation and chemotherapy may also be used to destroy any remaining cancer cells and lessen the chance of the tumor returning.
What else can Spiradenoma be?
Spiradenoma, a type of skin tumor, can show similar symptoms to other conditions. Therefore, doctors may need to consider and rule out the following conditions when diagnosing spiradenoma:
- Angiolipoma
- Dermatofibroma
- Epidermal inclusion cyst
- Leiomyoma
- Poroma
- Schwannoma
