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Benign adnexalAnogenitalICD-10 D28.0 (vulval), D29.4 (anogenital male)

Hidradenoma papilliferum

Vulval hidradenoma; mammary-like gland adenoma

Hidradenoma papilliferum is a benign apocrine adnexal tumour of anogenital skin, classically affecting the vulva, perineum or perianal region of adult women. It presents as a solitary, firm, skin-coloured to red papule or small nodule, 3–15 mm, often with discharge or bleeding. It is thought to arise from anogenital mammary-like glands. Histology is highly characteristic: a well-circumscribed dermal cystic nodule with complex papillary projections lined by columnar cells with decapitation secretion. Complete surgical excision is curative; recurrence after incomplete excision is rare.

CurrentLast reviewed 15 May 2026

Clinical features

  • Solitary, firm, dome-shaped, skin-coloured to red papule or small nodule, 3–15 mm.
  • Distribution — vulva (interlabial sulcus, labia majora), perineum, perianal region; rarely scrotum, nipple, eyelid.
  • Adult women (median age 30–50); reported in men anogenitally.
  • May bleed, discharge or ulcerate with trauma; pruritus is common.

Histology

  • Well-circumscribed dermal cystic nodule unconnected to the surface epidermis.
  • Complex papillary and tubular projections into the cystic cavity, lined by a double layer of cells — luminal columnar cells with decapitation secretion and outer myoepithelial cells.
  • Origin from anogenital mammary-like glands.
  • Differential — syringocystadenoma papilliferum (open to the surface, plasma-cell-rich stroma), tubular apocrine adenoma, malignant apocrine tumour (rare; demands wide excision).

Management

  • Complete surgical excision with histology — diagnostic and definitive.
  • Refer to gynaecology/colorectal as appropriate for anogenital surgical access.
  • Reassurance after complete excision; recurrence is rare.
  • Atypical or recurrent lesions warrant pathology review to exclude apocrine carcinoma.

References

  1. Meeker JH, Neubecker RD, Helwig EB. Hidradenoma papilliferum. Am J Clin Pathol; 1962.
  2. Scurry J, van der Putte SC. Lesions of anogenital mammary-like glands. Adv Anat Pathol; 2009.
  3. WHO Classification of Tumours Editorial Board. Skin Tumours, WHO Classification of Tumours, 5th ed., vol. 12. Lyon: IARC; 2025.

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