Clinical features

•Very rare benign tumor that shows a predilection for the distal extremities

•4F:1M

•Black> White races

•Slowly growing, asymptomatic, flesh colored or pink nodule (0.5-4 cm diameter)

Histological features

•Circumscribed nodule composed of ducts & cysts embedded in a dense fibrous stroma sometimes associated with lymphoid aggregates/germinal centers

•Ducts lined by double-layered epithelium- small inner, uniform cells with eosinophilic cytoplasm & vesicular/hyperchromatic nuclei with small nucleoli & outer myoepithelial cells

•No pleomorphism and mitoses are sparse of absent

•Pseudo-papillae (devoid of a fibrovascular core) are often conspicuous

Absense of true papillae (i.e with a fibrovascular core)

•Variable cribriform pattern

•Variable clear cell change

•Variable squamous differentiation

•Absence of decapitation secretion

•No necrosis, perineural infiltration or lymphovascular invasion

•CAM5.2, EMA & CEA+ve

•Myoepithelial cells SMA, calponin, p63 & s100+ve