DermDx: Bluish Nodule on Breast

Slideshow

  • Slide

A 34-year-old woman presents to the office requesting removal of a nodule on her right breast. She states that the lesion has been present for several years and is not painful. She denies personal or family history of breast cancer. Palpation with tenting demonstrates a 2.0-cm nodule with bluish coloration. Lymph nodes are not palpable and no other masses are found.

Apocrine hidrocystoma is a benign, dome-shaped, cystic neoplasm originating in apocrine sweat glands. The lesions typically present as solitary, asymptomatic papules or nodules that are translucent to bluish in hue. Most cases arise in middle-aged to older adults.1 Apocrine hidrocystomas...

Submit your diagnosis to see full explanation.

Apocrine hidrocystoma is a benign, dome-shaped, cystic neoplasm originating in apocrine sweat glands. The lesions typically present as solitary, asymptomatic papules or nodules that are translucent to bluish in hue. Most cases arise in middle-aged to older adults.1

Apocrine hidrocystomas usually present on the margins of the eyelids but have been reported to arise in multiple body parts such as the parotid gland and penis.2,3  Recently an apocrine hydrocystoma of the nipple has been reported.4 Multiple lesions may be associated with rare genodermatoses such as Schopf-Schulz-Passarge and Goltz-Gorlin syndrome.5

Diagnosis is often made clinically and confirmed by histology, which reveals a cystic lesion containing an inner layer of secretory columnar epithelium.  Simple needle aspiration is often curative. Multiple lesions have responded to carbon dioxide laser ablation.6

Stephen Schleicher, MD, is director of the DermDox Dermatology Centers in Pennsylvania, associate professor of medicine at Geisinger Commonwealth Medical College, and clinical instructor of dermatology at Arcadia University and Kings College.

References

1. Sarabi K, Khachemoune A. Hidrocystomas — a brief review. MedGenMed. 2006;8(3):57.

2. Kharrat I, Achour I, Thabet W, et al. Apocrine hidrocystoma of the parotid gland. Ear Nose Throat J. 2021:1455613211031028. doi:10.1177/01455613211031028

3. Val D, Val-Bernal JF.  Apocrine hidrocystoma of the foreskin. A case report and review of the literature. Rom J Morphol Embryol. 2017;58(2):651-653.

4. Magdaleno-Tapial J, Valenzuela-Oñate C, Martínez-Doménech Á, et al. Apocrine hidrocystoma on the nipple: the first report in this unusual location. Dermatol Online J. 2019:25(10):13030/qt89n4f0sf.

5. Hafsi W, Badri T, Shah F. Apocrine hidrocystoma. In: StatPearls. StatPearls Publishing; 2021 Jan–. Updated September 9, 2021.

6. del Pozo J, García-Silva J, Peña-Penabad C, Fonseca E. Multiple apocrine hidrocystomas: treatment with carbon dioxide laser vaporization. J Dermatolog Treat. 2001;12(2):97-100. doi:10.1080/095466301317085381

Next hm-slideshow in Derm DX