Malignant hidradenoma of the nasal tip mimicking basal cell carcinoma: A diagnostic pitfall

• Author Details:   
• Awani Shrivastava ^*
• Nitish Baisakhiya
• Ankita Baghel
• Shilpi Parihar
• Apoorva Shakti

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Malignant hidradenoma is a rare eccrine sweat gland tumor, most commonly occurring in the head and neck, followed by the extremities; however, involvement of the nasal tip is exceptionally uncommon. These tumors typically present as slow-growing, painless nodules and can mimic more common cutaneous malignancies, leading to diagnostic challenges. We report an 81-year-old female with a large, cauliflower-like mass over the nasal tip persisting for 3–4 years, clinically suspected as basal cell carcinoma due to its location and appearance. The patient underwent wide local excision with pedicled flap reconstruction, and histopathological evaluation confirmed malignant hidradenoma, with no nodal or distant metastasis. The unusual site and deceptive clinical appearance of this tumor emphasize the importance of including malignant hidradenoma in the differential diagnosis of nasal lesions. Early recognition, histopathological confirmation, and complete excision are crucial for reducing recurrence and ensuring optimal management.