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Lee DY, Han KM, Yoon JS. A malignant proliferating trichilemmal cyst arising on the elbow of a man: A case report and review of the literature. Medicine (Baltimore) 2023; 102:e34035. [PMID: 37352060 PMCID: PMC10289708 DOI: 10.1097/md.0000000000034035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/25/2023] Open
Abstract
INTRODUCTION Trichilemmal cysts (TCs) are common benign cysts that form from the hair follicles in the skin. Proliferating trichilemmal cysts (PTCs) are rare types of TCs characterized by rapid cellular proliferation. Malignant transformation of PTC (MPTC) is a rare adnexal tumor that account for <0.1% of all skin cancers. TCs and PTCs are benign tumors; however, MPTCs grow rapidly and are prone to metastasis. CASE PRESENTATION A 77-year-old man was referred to our hospital with a solitary pinkish mass on his left elbow. Trichilemmal carcinoma arising from a PTC was confirmed through excisional biopsy, and wide excision was performed. One month postoperatively, a cystic mass was observed and was suspected to have local recurrence; however, bursitis was confirmed after excisional biopsy. After 1 year of follow-up, the patient maintained an improvement without recurrence or any other surgical complications. CONCLUSIONS In addition to being a very rare disease, MTPC occurred in the elbow of a man who does not fit the general etiology; therefore, it is considered an interesting case, and we report this case for academic contribution.
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Affiliation(s)
- Dong Yun Lee
- Department of Plastic and Reconstructive Surgery, DongGuk University Medical Center, Seoul, South Korea
| | - Kang Min Han
- Department of Plastic and Reconstructive Surgery, DongGuk University Medical Center, Seoul, South Korea
| | - Jung Soo Yoon
- Department of Plastic and Reconstructive Surgery, DongGuk University Medical Center, Seoul, South Korea
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2
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Al-Wassia RK, Al-Qathmi MS. Microcystic adnexal carcinoma of the scalp treated with surgical resection along with chemoradiation: A case report and review of the literature. Saudi J Biol Sci 2021; 28:7117-7124. [PMID: 34867014 PMCID: PMC8626250 DOI: 10.1016/j.sjbs.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 11/29/2022] Open
Abstract
Microcystic adnexal carcinoma (MAC) is an infiltrative rare cutaneous neoplasm for which there are no consensus management guidelines because of the paucity of evidence-based practice; hence, the utility of their management is based only on previously published case reports. We report a case of a scalp lesion that was successfully treated using a combination of surgical resection, chemotherapy, and radiotherapy.
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Affiliation(s)
- Rolina K Al-Wassia
- Department of Radiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marwah S Al-Qathmi
- Department of Otolaryngology - Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
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3
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Quéro L, Fumagalli I, Benadon B, Mignot F, Guillerm S, Labidi M, Hennequin C. [Place of radiotherapy in the treatment of cutaneous carcinomas]. Cancer Radiother 2021; 25:593-597. [PMID: 34400089 DOI: 10.1016/j.canrad.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/03/2021] [Accepted: 07/25/2021] [Indexed: 11/24/2022]
Abstract
Basal cell carcinomas and cutaneous squamous cell carcinomas are among the most common cancerous tumors in the world. Their treatment is most often based on surgery. Adjuvant radiotherapy may be indicated in case of risk factors for recurrence or as an alternative to surgery if surgery is not feasible due to the patient's advanced age and/or co-morbidities or as an alternative to potentially mutilating surgery. Radiotherapy is also part of the therapeutic arsenal for rarer skin tumors such as Merkel cell carcinoma, cutaneous lymphomas, Kaposi's disease and cutaneous adnexal carcinomas.
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Affiliation(s)
- L Quéro
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France.
| | - I Fumagalli
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France
| | - B Benadon
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France
| | - F Mignot
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France
| | - S Guillerm
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France
| | - M Labidi
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France
| | - C Hennequin
- Service de cancérologie-radiothérapie, DMU ICARE, AP-HP, Nord, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010, Paris, France; Université de Paris, Paris, France
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4
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Behbahani S, Yeh CJ, Pinto JO, Wassef D, Povolotskiy R, Joseph N, Lambert WC, Schwartz RA. Microcystic adnexal carcinoma of the head and neck: Characteristics, treatment, and survival statistics. Dermatol Ther 2020; 34:e14559. [PMID: 33210380 DOI: 10.1111/dth.14559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/14/2020] [Accepted: 11/11/2020] [Indexed: 11/29/2022]
Abstract
Studies on microcystic adnexal carcinoma (MAC) survival rates have been limited. This effort examines the association of patient demographics, treatment modalities, and tumor stage with overall survival (OS) in patients with MAC of the head and neck. All cases of MAC with primary sites of the skin of the head and neck, confirmed histologically, and diagnosed from 2004 to 2016 in the National Cancer Database, were analyzed. We utilized Kaplan-Meier and Cox proportional-hazard models to analyze the characteristics and survival outcomes of the 415 cases that met the criteria. The mean age of diagnosis was 63.8 years (SD ±15.8). Mean OS was 10.8 years with 5- and 10-year OS being 81.0% and 68.0%, respectively. Women were more frequently affected (59.0%; P < .001). Stand-alone primary site surgery was the most common treatment (81.4%): 15.9% of patients were treated with postexcision radiation therapy (RT). 18.3% were treated with RT with or without surgery and/or chemotherapy. RT was independently associated with a decreased hazard of death (HR = 0.23; P = .044). MAC of the head and neck disproportionately affects whites, is more common in women, and has the potential to metastasize. Surgical excision is the commonest treatment; our study shows benefit from judicious RT.
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Affiliation(s)
- Sara Behbahani
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Christopher J Yeh
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jessica O Pinto
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - David Wassef
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Roman Povolotskiy
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Nia Joseph
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - W Clark Lambert
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Robert A Schwartz
- Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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5
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Collision tumor of microcystic adnexal carcinoma and squamous cell carcinoma discovered on Mohs sections. JAAD Case Rep 2020; 6:479-481. [PMID: 32490104 PMCID: PMC7256221 DOI: 10.1016/j.jdcr.2020.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Key Words
- BCC, basal cell carcinoma
- CEA, carcinoembryonic antigen
- CK, cytokeratin
- DTE, desmoplastic trichoepithelioma
- IHC, immunohistochemical
- MAC, microcystic adnexal carcinoma
- MMS, Mohs micrographic surgery
- PNI, perineural invasion
- SCC, squamous cell carcinoma
- SLNB, sentinel lymph node biopsy
- collision tumor
- cytokeratin 15
- immunohistochemistry
- microcystic adnexal carcinoma
- squamous cell carcinoma
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6
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Kim DW, Lee G, Lam MB, Harris EJ, Lam AC, Thomas T, Chau NG, Tishler RB. Microcystic Adnexal Carcinoma of the Face Treated With Definitive Chemoradiation: A Case Report and Review of the Literature. Adv Radiat Oncol 2019; 5:301-310. [PMID: 32280832 PMCID: PMC7136639 DOI: 10.1016/j.adro.2019.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/29/2019] [Accepted: 11/14/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- Daniel W Kim
- Department of Radiation Oncology Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Grace Lee
- Department of Radiation Oncology Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Miranda B Lam
- Department of Radiation Oncology Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Ethan J Harris
- University of Illinois College of Medicine, Chicago, Illinois
| | - Allen C Lam
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Tom Thomas
- Head and Neck Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts.,Head and Neck Reconstructive Surgery and Transoral Robotic Surgery, Atlantic Center for Head and Neck Surgery, Carol G. Simon Cancer Center, Morristown, New Jersey
| | - Nicole G Chau
- Harvard Medical School, Boston, Massachusetts.,Head and Neck Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Roy B Tishler
- Department of Radiation Oncology Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Head and Neck Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
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7
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Sasamura K, Matsubara D, Kojima M, Yuasa-Nakagawa K, Toda K, Miura K, Yoshimura R. Intensity Modulated Radiation Therapy for Syringomatous Carcinoma of the Face: A Case Report. Adv Radiat Oncol 2019; 4:473-477. [PMID: 31360802 PMCID: PMC6639763 DOI: 10.1016/j.adro.2019.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 03/17/2019] [Accepted: 03/31/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Kazuma Sasamura
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
- Corresponding author. 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Daigoro Matsubara
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mio Kojima
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Yuasa-Nakagawa
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuma Toda
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Miura
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Yoshimura
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
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8
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Mamic M, Manojlovic L, Suton P, Luksic I. Microcystic adnexal carcinoma—diagnostic criteria and therapeutic methods: case report and review of the literature. Int J Oral Maxillofac Surg 2018; 47:1258-1262. [DOI: 10.1016/j.ijom.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 01/15/2018] [Accepted: 03/08/2018] [Indexed: 12/22/2022]
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Abstract
BACKGROUND Microcystic adnexal carcinoma (MAC) is a rare, locally aggressive cutaneous neoplasm that commonly occurs on the face. OBJECTIVE The purpose of this article is to comprehensively review the current literature on MAC pertaining to epidemiology, pathogenesis, clinical presentation, histology, immunohistochemistry, prognosis, follow-up, and treatment. MATERIALS AND METHODS An extensive literature review was conducted using OVID MEDLINE and PubMed to identify articles relating to MAC. RESULTS Microcystic adnexal carcinoma typically presents as a skin-colored nodule on the face. The pathogenesis is mostly related to pilar and eccrine differentiation. Histologically, MAC can mimic syringoma, desmoplastic trichoepithelioma, and infiltrative basal cell carcinoma. Diagnosis is challenging because superficial shave biopsies may reveal only benign findings that do not warrant further management. A deep biopsy is mandatory for the correct diagnosis, and Mohs micrographic surgery provides the highest cure rate. CONCLUSION Microcystic adnexal carcinoma is a locally aggressive disease with histological margins that often far surpass what is clinically suspected. Mohs micrographic surgery is the standard of care for removal of these lesions. Patients with a history of MAC should be examined at least every 6 months for recurrence, metastasis, and development of additional skin cancers.
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10
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Surgery and Adjuvant Radiation for High-risk Skin Adnexal Carcinoma of the Head and Neck. Am J Clin Oncol 2017; 40:429-432. [PMID: 25599317 DOI: 10.1097/coc.0000000000000178] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Skin adnexal carcinoma (SAC) is a rare cutaneous malignancy that arises from sebaceous and sweat glands. These carcinomas are believed to behave more aggressively than cutaneous squamous cell carcinomas (SCC) with a propensity for local recurrence. The role of adjuvant radiotherapy in SAC is undefined. METHODS We retrospectively reviewed all cases of head and neck SAC treated with surgery and adjuvant radiation from 2000 to 2012 at a single institution. RESULTS Nine cases were identified. Median age was 67 (range, 52 to 88) years. The histologies were: adnexal carcinoma (n=1), adnexal carcinoma with sebaceous differentiation (n=1), adnexal carcinoma with squamous differentiation (n=1), skin appendage carcinoma (n=1), sclerosing sweat duct carcinoma (n=1), mucinous carcinoma (n=1), ductal eccrine adenocarcinoma (n=1), porocarcinoma (n=1), and trichilemmal carcinoma (n=1). All tumors were reviewed by a dermatopathologist to confirm the SAC diagnosis.All patients had undergone surgery. Indications for adjuvant radiation included involved lymph nodes (n=4), perineural invasion (n=2), nodal extracapsular extension (n=2), positive margin (n=1), high-grade histology (n=6), multifocal disease (n=2), and/or recurrent disease (n=5). Radiation was delivered to the primary site alone (n=3), to the draining lymphatics alone (n=2), or to both (n=4). One patient received concurrent cisplatin. Median dose to the primary site was 60 Gy and to the neck was 50 Gy.Median follow-up was 4.0 years (range, 0.6 to 11.4 y). Locoregional control was 100%. Five-year progression-free survival was 89%. There was 1 acute grade 3 toxicity and no greater than or equal to grade 2 late toxicities were recorded. CONCLUSIONS Surgery and adjuvant radiation for high-risk SAC offers excellent locoregional control with acceptable toxicity.
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11
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Kim UG, Kook DB, Kim TH, Kim CH. Trichilemmal Carcinoma from Proliferating Trichilemmal Cyst on the Posterior Neck. Arch Craniofac Surg 2017; 18:50-53. [PMID: 28913304 PMCID: PMC5556745 DOI: 10.7181/acfs.2017.18.1.50] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 11/11/2022] Open
Abstract
Trichilemmal cysts are common fluid-filled growths that arise from the isthmus of the hair follicle. They can form rapidly multiplying trichilemmal tumors-, also called proliferating trichilemmal cysts, which are typically benign. Rarely, proliferating trichilemmal cysts can become cancerous. Here we report the case of a patient who experienced this series of changes. The 27-year-old male patient had been observed to have a 1×1 cm cyst 7 years ago. Eight months prior to presentation at our institution, incision and drainage was performed at his local clinic. However, the size of the mass had gradually increased. At our clinic, he presented with a 5×4 cm hard mass that had recurred on the posterior side of his neck. The tumor was removed without safety margin, and the skin defect was covered with a split-thickness skin graft. The pathologic diagnosis was a benign proliferating trichilemmal cyst. The mass recurred after 4months, at which point, a wide excision (1.3-cm safety margin) and split-thickness skin graft were performed. The biopsy revealed a trichilemmal carcinoma arising from a proliferating trichilemmal cyst. This clinical experience suggests that clinicians should consider the possibility of malignant changes when diagnosing and treating trichilemmal cysts.
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Affiliation(s)
- Ui Geon Kim
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Dong Bee Kook
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Tae Hun Kim
- Department of Pathology, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Chung Hun Kim
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
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12
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Chaudhari SP, Mortazie MB, Blattner CM, Garelik J, Wolff M, Daulat J, Chaudhari PJ. Treatments for microcystic adnexal carcinoma--A review. J DERMATOL TREAT 2015; 27:278-84. [PMID: 26331917 DOI: 10.3109/09546634.2015.1089351] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous neoplasm presenting as a slow-growing, indurated nodule, papule or plaque. Clinically, the lesion can blend into the surrounding skin, obscuring borders and consequently delaying diagnosis histologically. Surgical and histologic techniques that emphasize examination of all margins may optimize management through early diagnosis and prevention of recurrences. OBJECTIVE This review aims to assess the current surgical and histology techniques that result in lower rates of tumor recurrence and, consequently, better clinical outcomes. METHODS A literature search of the PubMed database was conducted to identify studies examining wide local excision (WLE), Mohs micrographic surgery (MMS), radiotherapy (RT) and chemotherapy in the treatment of MAC. RESULTS WLE had a high likelihood of positive margins and local recurrence. MMS was found to have the lowest recurrence rates. Definitive RT could be considered for elderly patients or those who are poor surgical candidates, as large surgical defects may be required to obtain free margins with either WLE or MMS. Chemotherapy was found to be ineffective. CONCLUSION Complete margin evaluation with MMS permits complete tumor removal with subsequently low recurrence rate.
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Affiliation(s)
| | - Michael B Mortazie
- b Department of Dermatology , St. Joseph Mercy Hospital , Ann Arbor , MI , USA
| | | | - Jessica Garelik
- d Department of Dermatology , Albert Einstein College of Medicine , Bronx , NY , USA
| | - Marisa Wolff
- e Department of Dermatology , St. Barnabas Hospital , Bronx , NY , USA
| | - Jaldeep Daulat
- f Las Vegas Skin & Cancer Clinics , Las Vegas , NV , USA .,g Mohave Centers for Dermatology & Plastic Surgery , Kingman , AZ , USA , and
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13
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Wang Q, Ghimire D, Wang J, Luo S, Li Z, Wang H, Geng S, Xiao S, Zheng Y. Desmoplastic trichoepithelioma: A clinicopathological study of three cases and a review of the literature. Oncol Lett 2015; 10:2468-2476. [PMID: 26622873 DOI: 10.3892/ol.2015.3517] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 12/03/2014] [Indexed: 11/06/2022] Open
Abstract
Desmoplastic trichoepithelioma (DTE) is a rare benign adnexal tumor with the characteristic features of asymptomatic, solitary, annular, indurated and centrally depressed papules or plaques, most commonly occurring in younger individuals on the face. Microscopically and clinically, DTE may be difficult to distinguish from other cutaneous adnexal neoplasms, particularly syringoma, cutaneous metastatic breast cancer, morpheaform basal cell carcinoma and microcystic adnexal carcinoma. The present study reports three cases of DTE. The first case was of a 45-year-old male with an asymptomatic flesh-colored plaque below the right edge of the outer canthus that had been present for seven years. The second case was of a 23-year-old female with an asymptomatic skin lesion on the right cheek that had slowly and progressively increased in size. The third case was of a 26-year-old female who presented with a hard yellowish-white plaque, which gradually grew and formed a rectangular, 3×4-cm patch, on the tip of the left brow. This plaque was present for three years without evident cause or subjective symptoms. In all three cases, the routine systemic examinations and laboratory findings were normal. Histopathological and immunohistochemical findings from incisional biopsies of the lesions were consistent with a diagnosis of DTE. DTE treatment methods and immunohistochemical markers were analyzed by reviewing clinical pathological aspects in order to avoid a misdiagnosis and to provide the best available treatment approach for DTE.
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Affiliation(s)
- Qiongyu Wang
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Deepak Ghimire
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Juan Wang
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Suju Luo
- Department of Dermatology, Tianjin Hospital of Tianjin Medical University, Tianjin, P.R. China
| | - Zhengxiao Li
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Hao Wang
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Songmei Geng
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Shengxiang Xiao
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Yan Zheng
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
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14
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Zhou RR, Zhao QM, Zhang XD, Gan JB. Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature. Exp Ther Med 2015; 10:1202-1206. [PMID: 26622465 DOI: 10.3892/etm.2015.2614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 05/27/2015] [Indexed: 12/13/2022] Open
Abstract
Microcystic adnexal carcinoma (MAC) is a rare and locally aggressive adenocarcinoma with low-grade malignancy. The present study describes the first reported case and treatment of a Chinese male with a MAC located on the nasal dorsum and nosewing. A 44-year-old man presented with a nasal deformity caused by local repeated infections following an accidental injury to the nose 20 years previously. The nose had been injured by a brick, and treatment at a local hospital 12 years previously had resulted in a nasal scar and a gradually enlarging mass. A physical examination revealed a hypertrophic deformity of the nose and an indurated scar plaque, measuring 2.0×2.0 cm, on the nasal dorsum and nosewing. Microscopic examination revealed a tumor consisting of solid cell nests and a cystic structure with a capsular space. In addition, ductal cells of an adnexal cell origin were visible in the outer epithelium. The medial portion exhibited a microductal structure and invasion of deeper tissues without evident atypia. The tumor cells presented normal nuclear to cytoplasmic ratios and minimal mitotic activity. Pathological examination verified that the tumor was a MAC of low-grade malignancy. A complete surgical resection was performed via Mohs micrographic surgery (MMS), and reconstruction was achieved using an expanded rotational forehead skin flap. No tumor recurrence was detected after a three-year follow-up period. Therefore, for effective treatment of similar MAC cases, complete surgical resection using MMS is recommended, and successful reconstruction may be achieved using an expanded skin flap.
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Affiliation(s)
- Rong-Rong Zhou
- Department of Plastic Surgery, The 117 Hospital of People's Liberation Army, Hangzhou, Zhejiang 310013, P.R. China
| | - Qi-Ming Zhao
- Department of Plastic Surgery, The 117 Hospital of People's Liberation Army, Hangzhou, Zhejiang 310013, P.R. China
| | - Xu-Dong Zhang
- Department of Plastic Surgery, The 117 Hospital of People's Liberation Army, Hangzhou, Zhejiang 310013, P.R. China
| | - Jing-Bing Gan
- Department of Plastic Surgery, The 117 Hospital of People's Liberation Army, Hangzhou, Zhejiang 310013, P.R. China
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15
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Green B, Godden D, Brennan PA. Malignant cutaneous adnexal tumours of the head and neck: an update on management. Br J Oral Maxillofac Surg 2015; 53:485-90. [PMID: 25911053 DOI: 10.1016/j.bjoms.2015.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
Adnexal tumours form a heterogeneous group of relatively rare neoplasms. Many of them have a poor prognosis and treatment can sometimes be difficult and controversial. We summarise the latest publications relating to malignant cutaneous adnexal tumours of the head and neck, and give an update on their management. We discuss Merkel cell carcinoma and other rare malignant adnexal tumours including dermatofibrosarcoma protuberans and atypical fibroxanthoma.
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Affiliation(s)
- B Green
- Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK.
| | - D Godden
- Department of Oral & Maxillofacial Surgery, Gloucestershire Royal Hospital, UK.
| | - P A Brennan
- Department of Oral & Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK.
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Microcystic adnexal carcinoma: reconstruction of a large centrofacial defect. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2014; 2:e254. [PMID: 25506537 PMCID: PMC4255897 DOI: 10.1097/gox.0000000000000195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 08/13/2014] [Indexed: 02/06/2023]
Abstract
Summary: We report a rare case of a large facial microcystic adnexal carcinoma in an elderly patient who underwent several rounds of excision. The patient was left with a large facial defect and remaining positive margins. The decision was made to stop further excision and proceed with reconstructive surgery. We show that the patient’s function and quality of life were not impeded despite reconstruction in light of positive margins for tumor. We believe that this case will draw the surgeon’s attention to the possibility of palliative reconstruction in the treatment of a patient with large debilitating facial defects after microcystic adnexal carcinoma excision.
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Green M, Mitchum M, Marquart J, Bowden LP, Bingham J. Microcystic adnexal carcinoma in the axilla of an 18-year-old woman. Pediatr Dermatol 2014; 31:e145-8. [PMID: 25424223 DOI: 10.1111/pde.12430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Microcystic adnexal carcinoma (MAC) is an uncommon adnexal neoplasm with a predilection for the head and neck. The tumor rarely metastasizes but is locally aggressive and commonly demonstrates perineural invasion. MAC occurs most often in older adults. This report describes a young woman with a MAC in her left axilla who required two stages of Mohs micrographic surgery followed by a wide local excision because of persistent perineural invasion in close proximity to the brachial plexus. Other cases presenting in the pediatric age group are discussed.
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Affiliation(s)
- Margaret Green
- Dermatology Department, Walter Reed National Military Medical Center, Bethesda, Maryland
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Jfri A, Al Hawsawi K, Marghalani S, Alkhuzaie A. Microcystic adnexal carcinoma: unusual presentation. J Eur Acad Dermatol Venereol 2014; 30:165-7. [PMID: 25187439 DOI: 10.1111/jdv.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- A Jfri
- Dermatology Department, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - K Al Hawsawi
- Dermatology Department, King Abdul Aziz Hospital, Makkah, Saudi Arabia
| | - S Marghalani
- Dermatology Department, King Abdulaziz Medical City for National Guard, Jeddah, Saudi Arabia
| | - A Alkhuzaie
- General Surgery Department, King Abdul Aziz Hospital, Makkah, Saudi Arabia
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Sidhu HK, Patel RV, Goldenberg G. Dermatology clinics: what's new in dermatopathology: news in nonmelanocytic neoplasia. Dermatol Clin 2012; 30:623-41, vi. [PMID: 23021050 DOI: 10.1016/j.det.2012.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article reviews the recent dermatopathology literature involving nonmelanocytic neoplasia, with a focus on important work done over the last 5 years. The discussion includes advances in the understanding of Merkel cell carcinoma pathogenesis and prognosis; changes in the seventh edition of the American Joint Committee of Cancer staging manual in reference to staging of squamous cell carcinoma and Merkel cell carcinoma; newly described or rare histopathologic patterns and entities including squamoid eccrine ductal carcinoma, rippled-pattern adnexal neoplasms, onychomatricoma, spindle cell predominant trichodiscoma/neurofollicular hamartoma, and myoepithelioma; and microsatellite instability in sebaceous neoplasms of Muir-Torre syndrome and other tumors.
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Affiliation(s)
- Harleen K Sidhu
- Department of Pathology, Mount Sinai School of Medicine, One Gustave L Levy Place, New York, NY 10029, USA
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