A 28-year-old lady presented with multiple swellings in her left shoulder, associated with intermittent
pain since last one and a half years. Radiologic imaging revealed multiple, well-defined, subcutaneous lesions in her left supraclavicular region. Fine needle aspiration cytology (FNAC) smears were initially reported as
Ewing sarcoma, elsewhere. On review, the smears showed cohesive clusters of round-to-oval cells with scant cytoplasm, which were focally arranged in an acinar-rosetting pattern around hyaline "droplets/bodies," along with few scattered lymphocytes against a background of red blood cells. The diagnosis considered was adnexal
tumor. Subsequent biopsy from the multiple lesions confirmed the diagnosis of
eccrine spiradenoma. By immunohistochemistry,
tumor cells were positive for CK7,
epithelial membrane antigen (focally),
S100 protein, and
tyrosine-protein kinase Kit(C-KIT) /Cluster of differentiation (CD117). This case underscores the value of FNAC in skin adnexal
tumors and constitutes as the first case report of multiple
eccrine spiradenomas, initially misdiagnosed as
Ewing sarcoma. Literature review of similar reported cases with treatment implications are presented.