Giant vascular eccrine spiradenoma

A 60-year-old man suffering from cardiac insufficiency consulted the Dermatology Department, Inönü University Turgut Ozal Medical Center, because of a bleeding tumor on his right hypochondrium. The tumor had begun as a small nodule approximately 5 years before, and had grown slowly with time. A small, superficial ulcer had appeared on the lesion approximately 6 months previously, and slight bleeding had occasionally occurred. The patient had no pain and no other complaint except bleeding. Dermatologic examination revealed a violaceous, ulcerated, and bleeding tumoral lesion below the mid-portion of the right costochondral line. The tumor was a non-tender, hemispheric mass, approximately 3-4 cm in size, adherent to the epidermis, but movable on the underlying tissue. An incisional biopsy was performed with diagnoses of dermatofibrosarcoma protuberans and desmoid tumor. Histopathologic examination revealed prominent blood-filled vascular spaces and clearly delimited cords, showing two types of cell. The vascular spaces contained a periodic acid-Schiff (PAS)-positive, granular, eosinophilic material. There was no malignant transformation. The lesion was totally excised and primarily sutured.