WOFAPS 2025 8th World Congress of Pediatric Surgery

Yavuz Yılmaz ¹, Şükrüye Demirkaya ², Esra Karakuş ³, Seda Şahin ⁴

¹ Department of Pediatric Surgery, Health Sciences University Gulhane Medical Faculty
² Ankara Bilkent City Hospital Department of Pediatric Surgery
³ Ankara City Hospital, Department of Pathology, Bilkent, Ankara
⁴ ANKARA Yüksek İhtisas Universitesi Department of Pediatric Hematology Oncology

Introduction: Clear cell hidradenoma (CCH) is a rare adnexal tumor, typically occurring in the head, neck, and extremities. Breast involvement is exceedingly rare, with most reported cases in middle-aged or elderly women. We present the youngest male case of CCH in the breast reported in the literature.

Case Presentation: A 6-year-old male presented with a non-healing, ulcerated, hyperemic lesion under the left nipple. Ultrasonography revealed a 23x15 mm subcutaneous nodule with cystic components. Initial excision revealed CCH with positive margins, prompting re-excision. Histopathology showed polyhedral and clear cells, confirming CCH.

Discussion: CCH, previously misclassified as carcinoma, arises from sweat glands or breast ducts. While typically benign, incomplete excision can lead to recurrence (5%). Malignant transformation, though rare, necessitates complete resection. Only 34 breast cases have been reported, with just nine in males; our case is the youngest. Diagnostic challenges include mimicking intraductal papilloma or benign cysts, emphasizing the need for histopathological confirmation.

Conclusion: This case highlights CCH as a rare differential diagnosis for pediatric breast masses. Complete surgical excision is critical to prevent recurrence. Awareness of CCH in younger populations can aid timely diagnosis and management.