45 year old with a supraclavicular mass. Biopsy revealed this lesion

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Sections examined show a solidcystic neoplasm located in the dermis clearly separated from the epidermis comprising of lobules and nests of two types of cell population ; tumor cells with abundant clear cytoplasm with well defined cytoplasmic boundaries and hyperchromatic nuclear chromatin and other cells population with moderate eosinophilic cytoplasm . The cystic spaces are lined by low cuboidal epithelium with few of them filled with homogenous eosinophilic material .Few of the tumor cells show morules of squamous metaplastic change. The overlying epidermis is intact and thinned out. No evidence of lymphoid population noted in the sections examined No atypical mitotic figures or evidence of necrosis noted Impression Biopsy Supraclavicular Mass - Eccrine Acrospiroma / Nodulocystic Hidradenoma /Clear cell Hidradenoma (Note: Malignant transformation is rare in Acrospiroma; to look for presence of atypical mitoses ; necrosi , tumor atypia to rule out) Differential Diagnosis Metastatic tumor deposits of Clear Cell Renal Cell Carcinoma Advice PAS staining Correlation with Clinical and Radiological Findings IHC for confirmation Thanku

Benign Skin Adnexal Tumor.*Eccrine Acrospiroma. *Nodular/Nodulocystic Hidradenoma.

Benign dermal adnexal tumor Clear cell hidradenoma.

benign skin adnexal neoplasm-nodular hidradenoma

Eccrine acrospiroma

Advice AE1/AE3, PAX 8 for RCC. Synaptophysin and chromogranin to rule out Neuroendocrine malignancy.

And also CK7 to rule out papillary RCC
1

Meatstasis of renal cell carcinoma

Nodular hydradenoma

Mets most likely from kidney

Mets RCC

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