A case report of a rare incidence adnexal nodular hidradenoma mimicking as simple ganglion cyst in hand

Abstract

Soft tissue swelling of hand is a common condition presenting in orthopedic outpatient department (OPD). Simple ganglion cyst is the most prevalent presenting disorder among the various differential diagnoses for this ailment, which include ganglion cyst, inclusion cyst, giant cell tumor of tendon sheath, enchondroma, carpal bossing, leiomyoma, and adnexal tumors. A 75-year-old male patient presented with soft tissue swelling over dorsum of his left hand, which was insidious in onset and painless in nature at initial stages, but over the past 6 months it grew over to become of approximately 7×3 cm in size, and now causing slight pain and discomfort to patient. Primary investigation like X-ray, ultrasonography and magnetic resonance imaging (MRI) was done. Clinical and radiological investigation was suggestive of simple ganglion cyst. So patient was operated for it as surgical excision and tissue biopsy was sent for histological examination to arrive at definitive diagnosis of the condition and further line of management. Histological finding of tissue biopsy was suggestive of adnexal nodular hidradenoma with nodular and cystic areas of differentiation. Thus, before drawing a final diagnosis, a rare tumor like adnexal hidradenoma should also be taken into account as a differential diagnosis. This aids in the planning of the patient's future course of treatment. This instance emphasizes the significance of tracing reports prior to repeat surgery and submitting biopsies of all hand lesions for histological testing.