Morphological and Immunohistochemical Strategies in Diagnosing Cutaneous Adnexal Tumors: A Five-Year Study

Summary: Background: Cutaneous adnexal tumors (CATs) are rare, complex neoplasms that pose diagnostic challenges due to their diverse morphology. Accurate diagnosis is essential to differentiate them from epithelial tumors and metastases. Objective: To analyze the histopathological patterns of CATs and assess the role of immunohistochemistry (IHC) in distinguishing these tumors from other skin neoplasms. Methods: A five-year study (2019-2024) involving 60 CAT cases was conducted using retrospective and prospective data. Results: • Total Cases: 60 (42 retrospective, 18 prospective). • Gender Distribution: 53.3% males, 46.7% females (M:F ratio 1.14:1). • Age Group: Most common in 41-50 years (18.3%). • Tumor Types: Benign in 90% of cases. Hair follicle and sweat gland tumors were equally prevalent (43.3% each), with sebaceous tumors in 13.3%. • Anatomic Location: Predominantly in the head and neck region (55%), especially the face (30%). • Diagnostic Challenges: 9 cases required IHC to confirm diagnosis. • Notable Finding: All sweat gland carcinomas occurred exclusively in males, deviating from global trends. Conclusion: Morphological evaluation is the primary diagnostic tool for CATs, with IHC aiding in complex cases. The male-only occurrence of sweat gland carcinomas is a novel finding with potential clinical relevance.