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Adenoid Cystic Carcinoma (ACC) is a malignant tumour more commonly seen in salivary glands and rarely arises from the skin as adnexal tumour. Cutaneous ACC is a rare malignant adnexal tumour of eccrine origin. It has an indolent course and rarely metastasizes. Hereby, authors report a case of 48-year-old male with complaints of swelling on right forehead present for the past four years. Clinical diagnosis of infected sebaceous cyst was made and excised with simple excision. The swelling reappeared within 15 days of first surgery. The cytological examination of the swelling revealed abundant cellularity with predominantly cohesive clusters of monomorphic population of cells centered around eosinophilic hyaline globules suggestive of ACC. Retrieval of previous biopsy report revealed diagnosis of ACC reaching the margins of excision, the report of which was neither collected by either operating surgeon nor by the patient. Histopathological examination revealed classical cribriform pattern of arrangement of tumour cells with perineural infiltration by tumour cells. Immunohistochemistry further confirmed the diagnosis. The present case report brings out the importance of clearance of surgical margins in malignant tumours, including skin adnexal tumours. It also highlights the importance of histopathological examination of benign looking skin adnexal tumours. [ABSTRACT FROM AUTHOR]

Malignant nodular hidradenoma (MNH) also known as hidradenocarcinoma is very rare adnexal tumor with exceedingly low incidence of 0.001%. The recognition is very important because eccrine carcinomas have potential of local destruction and distant metastasis. Given the relative paucity of published data with only just over 50 case reports and small case series, there is little information available on the natural history and appropriate management for this disease. It has been reported most frequently in the head and neck and rarely on the extremities. There is no consensus treatment for metastatic hidradenocarcinoma since it is a rare and aggressive tumor. We report a rare case of MNH in a 70-year-old female presented with inguinal lymphadenopathy and discuss cytological findings and histopathological features with review of literature. Adnexal tumors need thorough histopathological analysis to conclude their biological behavior. This study will highlight the importance of appropriate wide excision of primary adnexal tumors and thereby preventing metastatic presentations in future. [ABSTRACT FROM AUTHOR]

Pilomatrixoma (PMX) is a skin appendage tumor of hair matrix origin, which usually occurs on the face or upper extremities. Although the lesion can appear at any age, it is commonly seen in children and is more common in females. Despite being better defined, pilomatricomas continue to be frequently misdiagnosed and are not usually considered in differential diagnoses, either in clinical set‑upor during cytological reporting. They typically present as a superficial, firm, solitary, slow‑growing, painless mass in the dermis. The overlying skin may be normal or exhibit a bluish‑red discoloration or ulceration. We report an 18‑year‑old girl presented with tender, subcutaneous nodule with overlying skin showing atrophy and hypopigmentation. Clinically, it was diagnosed as neurofibroma and sent for FNAC. We offered precise diagnosis of pilomatrixoma on cytological examination, (where chances of wrong diagnosis are very high) and it was subsequently confirmed by histopathology. We discuss the varied clinical presentations, diagnostic difficulties, and differential diagnoses of PMX. [ABSTRACT FROM AUTHOR]

The diagnosis of Nodular Fasciitis is a very challenging on cytological aspirations. Even in histopathological sections, it can be sometimes be mistaken for soft tissue sarcomas due to its high cellularity, presence of mitotic figures, poor circumscription and degenerative myxoid areas. Most commonly, nodular fasciitis is seen on extremities; and sub-cutaneous form is most common. We are hereby reporting a case of nodular fasciitis at a rare site (head and neck area) in its rare form (intra-muscular type: originating within sternocleidomastoid muscle), which was clinically suspected as a malignancy arising from solitary thyroid nodule. Cytological diagnosis was issued as benign spindle cell lesion (where chances of a misdiagnosis as malignant are very high), thereby preventing radical surgery. It was subsequently confirmed as intra-muscular nodular fasciitis after histopathological examination. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the medical case of intra-abdominal cystic lymphangioma in a 28-year-old woman with complaints of progressive distension of abdomen and chronic pelvic discomfort.