{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T03:04:58Z","timestamp":1778555098698,"version":"3.51.4"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,8,18]],"date-time":"2018-08-18T00:00:00Z","timestamp":1534550400000},"content-version":"vor","delay-in-days":229,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The authors present a \u201cfour-step\u201d integrated surgical protocol to treat a rare case of multiple giant eccrine spiradenoma (ES) of the head and neck in a young patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>\n                      An 18-year-old female patient presented with multiple swellings in the head and neck regions. The patient had a severe psychological trauma with a negative impact on her social life. Physical examination revealed multiple papulo-nodular swellings measuring between 5 cm \u00d7 8 cm and up to 10 cm \u00d7 20 cm in size with cerebriform aspect and soft consistency. Major lesions were located in the scalp, frontal area, neck, occipitotemporal, and retroauricular regions. Tissue biopsy found a benign composite adnexal neoplasm consisted in ES, trichoepithelioma, and cylindroma, a typical feature of Brooke-Spiegler Syndrome. A staged excision was planned, and available reconstructive options were considered. Scalp reconstruction included tissue expansions, advancement flaps, skin grafts, and dermal regeneration template (Integra\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ). All treatments were successful, and no recurrence was observed. The patient returned to a normal social life, and a radical excision with satisfying aesthetic results was achieved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Although adnexal tumors are benign in most of the cases, these lesions are prone to arise in the craniofacial region, thereby causing aesthetic discomfort associated with pain, hemorrhage, and infection to the patient every day. Furthermore, there is a potential risk of malignant transformation. These concerns demonstrate the need to establish a surgical protocol for the treatment of adnexal tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our integrated surgical approach showed excellent aesthetic and functional results with benefits to the patient's life and complete oncological excision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2018.08.021","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T18:53:10Z","timestamp":1536778390000},"page":"277-281","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["A rare case of Brooke-Spiegler syndrome"],"prefix":"10.1097","volume":"51","author":[{"given":"A.","family":"Portincasa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Cecchino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.M.C.","family":"Trecca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Lembo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Annacontini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Ciancio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Corsi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Cassano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Parisi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-70-20260114","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1001\/archderm.1956.01550030001001","article-title":"Eccrine spiradenoma","volume":"73","author":"Kersting","year":"1956","journal-title":"AMA Arch Derm"},{"key":"R2-70-20260114","first-page":"38","article-title":"A rare case of multiple segmental eccrine spiradenomas","volume":"4","author":"Englander","year":"2011","journal-title":"J. Clin. Aesthet. Dermatol"},{"key":"R3-70-20260114","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s00238-015-1103-4","article-title":"A rare case of eccrine spiradenoma-treatment and management","volume":"39","author":"Dhua","year":"2016","journal-title":"Eur. J. Plast. Surg"},{"key":"R4-70-20260114","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.3892\/etm.2014.1906","article-title":"Differential diagnosis of eccrine spiradenoma: a case report","volume":"8","author":"Zheng","year":"2014","journal-title":"Exp. Ther. Med"},{"key":"R5-70-20260114","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3315\/jdcr.2015.1208","article-title":"Brooke-spiegler syndrome - an underrecognized cause of multiple familial scalp tumors: report of a new germline mutation","volume":"9","author":"Pinho","year":"2015","journal-title":"J. Dermatol. Case Rep"},{"key":"R6-70-20260114","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1590\/abd1806-4841.20142194","article-title":"Syndrome in question. Brooke-spiegler syndrome","volume":"89","author":"Lavorato","year":"2014","journal-title":"An Bras. Dermatol"},{"key":"R7-70-20260114","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1097\/SCS.0b013e31818b4143","article-title":"Malignant eccrine spiradenoma of the scalp","volume":"19","author":"Seyhan","year":"2008","journal-title":"J. Craniofac. Surg"},{"key":"R8-70-20260114","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/j.1600-0560.2009.01320.x","article-title":"Malignant eccrine spiradenoma: a new case report","volume":"37","author":"Ben Brahim","year":"2010","journal-title":"J. Cutan. Pathol"},{"key":"R9-70-20260114","first-page":"388","article-title":"Malignant transformation of eccrine spiradenoma","volume":"11","author":"Dabska","year":"1972","journal-title":"Pol. Med. 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