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Kim MJ, Mun JH. Mohs micrographic surgery for the management of primary cutaneous cribriform carcinoma of the back. J Dtsch Dermatol Ges 2024; 22:584-586. [PMID: 38396117 DOI: 10.1111/ddg.15339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/16/2023] [Indexed: 02/25/2024]
Affiliation(s)
- Min Jae Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University Hospital, Seoul, Republic of Korea
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2
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Kim MJ, Mun JH. Mikrographische Chirurgie nach Mohs bei einem primär kutanen kribriformen Karzinom am Rücken. J Dtsch Dermatol Ges 2024; 22:584-586. [PMID: 38574031 DOI: 10.1111/ddg.15339_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/16/2023] [Indexed: 04/06/2024]
Affiliation(s)
- Min Jae Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University Hospital, Seoul, Republic of Korea
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3
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Yilmaz A, Goker B, Gedikoglu MG, Ayvaz M, Tokgozoglu AM. Primary Cutaneous Adenoid Cystic Carcinoma in a Rare Location With an Immune Response to a BNT162b2 Vaccine: A Case Report. JBJS Case Connect 2024; 14:01709767-202406000-00007. [PMID: 38608126 DOI: 10.2106/jbjs.cc.23.00499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
CASE In this report, a rare case of primary cutaneous adenoid cystic carcinoma (PCACC) localized in the subcutaneous tissue of the scapular region that grew after BNT162b2 corona virus disease of 2019 (COVID-19) vaccination is presented and may be explained by CD4 and CD8 cell infiltration. The BNT162b2 mRNA vaccine has been associated with a multisystem inflammatory syndrome (MIS-V). A comparable immune reaction could potentially enhance tumor growth rate. CONCLUSION Primary cutaneous adenoid cystic carcinomas are rare tumors with unique locations. Further studies with case series are required to establish management algorithms for PCACC and investigate the potential effect of vaccination.
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Affiliation(s)
- Abdurrahman Yilmaz
- Department of Orthopaedics and Traumatology, Hacettepe University, Faculty of Medicine, Altindag, Ankara, Turkey
| | - Barlas Goker
- Department of Orthopaedics and Traumatology, Hacettepe University, Faculty of Medicine, Altindag, Ankara, Turkey
| | | | - Mehmet Ayvaz
- Department of Orthopaedics and Traumatology, Hacettepe University, Faculty of Medicine, Altindag, Ankara, Turkey
| | - Ahmet Mazhar Tokgozoglu
- Department of Orthopaedics and Traumatology, Hacettepe University, Faculty of Medicine, Altindag, Ankara, Turkey
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4
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Andrew K, Carr JM, Roberts C. Rare skin appendage tumour on the right leg: a case of primary cutaneous cribriform carcinoma. BMJ Case Rep 2023; 16:e254781. [PMID: 37142284 PMCID: PMC10163513 DOI: 10.1136/bcr-2023-254781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
A woman in her 60s presented with a longstanding history of a purplish, fleshy and pedunculated nodule on the right shin on a background of bilateral lower limb lymphoedema. A shave biopsy with double curettage of the base of the lesion revealed a nodular tumour with hyperchromatic basaloid cells arranged in a cribriform pattern and encircling eosinophilic substance. Immunohistochemistry staining showed cells positive for pancytokeratin, low molecular weight keratin, BerEP4 and negative for cytokeratin 20. There were no clinical or radiological features of primary visceral malignancy. These histological and immunohistochemical features favour a diagnosis of primary cribriform carcinoma of the skin. This is a rare, indolent skin appendage tumour of presumed apocrine origin with no reported cases in the literature of metastasis or local recurrence after excision.
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Affiliation(s)
- Kashini Andrew
- Dermatology Department, University Hospitals Birmingham NHS Foundation Trust, Solihull, UK
| | - James M Carr
- Dermatology Department, University Hospitals Birmingham NHS Foundation Trust, Solihull, UK
| | - Claudia Roberts
- Histopathology Department, University Hospitals Birmingham NHS Foundation Trust, Solihull, UK
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5
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Bishop JA, Williams EA, McLean AC, Gagan J, Rooper LM, Jordan RCK, LeBoit PE. Microsecretory adenocarcinoma of the skin harboring recurrent SS18 fusions: A cutaneous analog to a newly described salivary gland tumor. J Cutan Pathol 2023; 50:134-139. [PMID: 35690998 DOI: 10.1111/cup.14271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/27/2022] [Accepted: 06/06/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Microsecretory adenocarcinoma (MSA) is a newly described salivary gland neoplasm characterized by MEF2C::SS18 fusions. MSA was previously thought to occur exclusively in salivary glands. Here, we expand the spectrum of known primary sites of this tumor by describing a series of cutaneous tumors with analogous findings. METHODS We identified four cutaneous primary tumors with histopathologic features identical to MSA of the salivary glands. These cases were evaluated by immunohistochemistry, fluorescence in situ hybridization (FISH) for SS18 rearrangement and targeted RNA-sequencing. We also queried a pan-tumor database of advanced carcinomas for MEF2C::SS18. RESULTS The cases occurred in men ranging from 61 to 74 years (mean, 68). They arose from the skin of the nose, chin, scalp, and external auditory canal. All included cords/microcysts of eosinophilic cells with bland oval nuclei and bluish mucin within fibromyxoid stroma. The scalp tumor also exhibited high-grade transformation (marked atypia, elevated mitotic rate, and necrosis), a feature unreported in salivary MSA. By immunohistochemistry, all cases were positive for S100. Two showed a myoepithelial component positive for p40 and smooth muscle actin or calponin. Three cases harbored MEF2C::SS18 by RNA sequencing, while one with limited tissue had SS18 rearrangement via FISH. Two patients had no evidence of recurrence or metastasis in limited follow-up (3 and 6 months). The pan-tumor database query also did not identify MEF2C::SS18 in any advanced cutaneous carcinomas. CONCLUSION This report expands the sites that can be involved by MSA. Similar to salivary cases, MEF2C::SS18 represents a recurrent fusion in MSA of the skin. Unusual features in cutaneous cases not seen in salivary MSA include one case with high-grade transformation and two cases with a myoepithelial cell component. Identification of this fusion expands the spectrum of salivary-analog cutaneous tumors and aids in precise tumor classification.
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Affiliation(s)
- Justin A Bishop
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Erik A Williams
- UCSF Dermatopathology & Oral Pathology Service, Department of Pathology and Dermatology, University of California, San Francisco, California, USA
| | - Anne C McLean
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jeffrey Gagan
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Lisa M Rooper
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Richard C K Jordan
- UCSF Dermatopathology & Oral Pathology Service, Department of Pathology and Dermatology, University of California, San Francisco, California, USA
| | - Philip E LeBoit
- UCSF Dermatopathology & Oral Pathology Service, Department of Pathology and Dermatology, University of California, San Francisco, California, USA
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6
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Panse G. Microsecretory adenocarcinoma: Cutaneous counterpart of a newly described salivary gland tumor with recurrent MEF2C::SS18 fusion. J Cutan Pathol 2023; 50:188-190. [PMID: 36308392 DOI: 10.1111/cup.14349] [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: 08/18/2022] [Revised: 09/26/2022] [Accepted: 10/15/2022] [Indexed: 01/24/2023]
Abstract
Microsecretory adenocarcinoma (MSA) is a distinctive low-grade salivary gland tumor with a novel MEF2C::SS18 fusion. Although MSA most commonly occurs in the oral cavity, cases of MSA involving skin have been described recently. Histopathologically, MSA is characterized by microcystic tubules with basophilic luminal secretions, a fibromyxoid stroma and cells with eosinophilic or clear cytoplasm, and a unique immunohistochemical profile (S100+, SOX10+, p63+, and p40-). Cutaneous MSA may rarely demonstrate high-grade features. Follow-up studies have shown MSA to be an indolent tumor, without local recurrence or metastasis after complete surgical excision in the vast majority of cases. It is important to recognize the histopathological features of this unique tumor with a novel MEF2C::SS18 fusion that may occur in skin and to utilize appropriate molecular studies for accurate diagnosis.
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Affiliation(s)
- Gauri Panse
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
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7
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Reappraisal and literature review of primary cutaneous cribriform apocrine carcinoma. Arch Dermatol Res 2023; 315:7-16. [PMID: 35124722 DOI: 10.1007/s00403-022-02323-5] [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: 08/24/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 01/07/2023]
Abstract
Primary cutaneous cribriform apocrine carcinoma (PCCAC) is an exceedingly rare sweat gland carcinoma. Clinically, it most often presents as a singular, asymptomatic nodule or cyst on the extremities of middle-aged patients and follows an indolent course. Both visceral and cutaneous cribriform tumors exist in nature. While a cribriform pattern is well recognized in tumors of visceral organs, there is a paucity in the literature on the defining characteristics for primary cutaneous tumors. Consensus regarding diagnostic criteria, etiology, and management protocols has yet to be achieved. We conducted an extensive literature review using pre-determined search criteria, resulting in 12 identified case reports and series on PCCAC that were subsequently analyzed. All data were compiled to provide a comprehensive update on the existing information regarding clinical presentation, histopathology, and management of reported PCCACs, as well as differential diagnosis, controversial issues, and recommendations for future considerations.
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8
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Goto K, Oka K, Sato M, Honma K, Emanuel PO. Anastomosing squamoid adenoma: clinicopathological analysis of three cases of a novel sweat ductal adnexal tumour with distinctive histopathological features. Pathology 2022; 55:564-568. [PMID: 36720656 DOI: 10.1016/j.pathol.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/27/2022] [Accepted: 10/20/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Keisuke Goto
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan; Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan; Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan; Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan; Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan; Department of Clinical Laboratory and Diagnostic Pathology, Osaka National Hospital, Osaka, Japan; Department of Dermatology, Hyogo Cancer Center, Akashi, Japan; Department of Dermato-oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.
| | - Kazumasa Oka
- Department of Diagnostic Pathology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan
| | - Makoto Sato
- Department of Plastic Surgery, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan
| | - Keiichiro Honma
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
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9
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Xiao Z, Zhang J, Guo Y, Ji C. Primary eccrine carcinoma with polymorphous features in a 20-year-old man. Indian J Dermatol Venereol Leprol 2022; 88:803-807. [PMID: 36332086 DOI: 10.25259/ijdvl_613_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 05/01/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Zhixun Xiao
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jing Zhang
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Ying Guo
- RWJ University Hospital Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Chao Ji
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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10
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Adnexal and Sebaceous Carcinomas. Dermatol Clin 2022; 41:117-132. [DOI: 10.1016/j.det.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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[Translated article] Primary Cutaneous Cribriform Carcinoma. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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12
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Carcinoma cribiforme cutáneo primario. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:740-741. [DOI: 10.1016/j.ad.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/27/2020] [Accepted: 01/10/2021] [Indexed: 11/24/2022] Open
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13
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Retroperitoneal Metastatic Apocrine Gland Ductal Adenocarcinoma in a Beagle Dog. Vet Sci 2022; 9:vetsci9050234. [PMID: 35622762 PMCID: PMC9143555 DOI: 10.3390/vetsci9050234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/01/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022] Open
Abstract
Tumors of sweat glands usually originate from apocrine glands and can develop throughout the body but are rare in dogs. This report describes the retroperitoneal metastasis of primary cutaneous apocrine adenocarcinoma. An 8-year-old, spayed female beagle dog, weighing 11.7 kg, presented with a history of anorexia, hypodynamia, and weight loss. Clinical examination, radiography, ultrasonography, and computed tomography revealed a skin mass on the dorsum of the right metatarsal region, an enlarged ipsilateral popliteal lymph node, and a retroperitoneal mass. Fine-needle aspiration cytology of the popliteal lymph node suggested metastasis of an apocrine sweat gland tumor. Surgical excision of the skin mass, popliteal lymph node, and retroperitoneal mass was performed. The retroperitoneal mass was diagnosed as a metastasis of primary cutaneous apocrine adenocarcinoma. Immunohistochemistry revealed that the tumor cells were positive for cytokeratin 7 but negative for cytokeratin 20 and S100 proteins. There were no postoperative complications, except for temporary hindlimb edema, including local recurrence or metastasis, in the 6-month postoperative follow-up period. This case illustrates that although malignant apocrine gland tumors are rare in dogs, a wide resection of primary cutaneous apocrine gland adenocarcinomas is recommended because of the risk of local invasion or distant metastasis.
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14
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The Utility of Myoepithelial Cell Layer Identification in Adnexal Carcinomas. Am J Dermatopathol 2022; 44:155-162. [PMID: 35171883 DOI: 10.1097/dad.0000000000001844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The distinction of metastatic carcinomas to the skin (MCS) from cutaneous adnexal carcinomas can pose a significant diagnostic challenge. The differentiation between (MCS) from a primary cutaneous adnexal tumor is one of the most difficult tasks in the field of dermatopathology, and immunohistochemistry has only been partially helpful in solving this problem. In routine diagnostic surgical pathology, it is essential to identify the myoepithelial cell layer by immunohistochemistry to distinguish between an in situ and invasive breast carcinomas and when establishing the presence of microinvasion. The purpose of this study was to evaluate the role of myoepithelial cell layer expression in difficult cases of cutaneous adnexal carcinomas in which histologically it was challenging to separate them from MCS. We studied 38 adnexal carcinomas and evaluated them for myoepithelial markers to confirm the primary nature of the neoplasm. The used markers to search for myoepithelial cell layer retention included calponin, p63, and smooth muscle actin. Of the 38 cases, we found that 13 cases showed myoepithelial layer retention, confirming the primary cutaneous origin of the neoplastic process. The results of our study suggest that the presence of an identifiable retention of the myoepithelial cell layer in adnexal carcinomas could be a useful adjunct observation in the diagnosis of primary adnexal carcinomas, especially in the clinical setting of a questionable primary adnexal versus metastatic neoplasm.
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15
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Battistella M, Balme B, Jullie ML, Zimmermann U, Carlotti A, Crinquette M, Frouin E, Macagno N, Ortonne N, Lamant L, de la Fouchardiere A, Aubriot-lorton MH, Durand L, Josselin N, Franck F, Chatelain D, Lemasson G, Algros MP, Durlach A, Machet MC, Courville P, Osio A, Seris A, Mortier L, Jouary T, Cribier B. Impact of expert pathology review in skin adnexal carcinoma diagnosis: Analysis of 2573 patients from the French CARADERM network. Eur J Cancer 2022; 163:211-221. [DOI: 10.1016/j.ejca.2021.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/19/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
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16
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Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation. Int J Mol Sci 2021; 22:ijms22105077. [PMID: 34064849 PMCID: PMC8151110 DOI: 10.3390/ijms22105077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary treatment, affecting their outcome. The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors.
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17
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Boettler M, Hickmann MA, Travers JB. Primary Cutaneous Cribriform Apocrine Carcinoma. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e927744. [PMID: 33386383 PMCID: PMC7784586 DOI: 10.12659/ajcr.927744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Patient: Male, 56-year-old Final Diagnosis: Apocrine carcinoma Symptoms: Lesion on skin Medication: — Clinical Procedure: — Specialty: Dermatology
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Affiliation(s)
| | | | - Jeffrey B Travers
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.,Department of Dermatology, Boonshoft School of Medicine, Wright State University, Dayton, USA.,Dayton VA Medical Center, Dayton, USA
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18
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Lee H, Won CH, Park CS. A case of cribriform carcinoma of the skin: a newly described rare condition. J Pathol Transl Med 2020; 55:68-74. [PMID: 33260289 PMCID: PMC7829579 DOI: 10.4132/jptm.2020.10.05] [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: 08/10/2020] [Accepted: 10/05/2020] [Indexed: 11/22/2022] Open
Abstract
Primary cribriform carcinoma of the skin is an indolent, rare, adnexal tumor. Although its malignant potential remains uncertain, no recurrence or metastasis has been reported. A 33-year-old man presented with a solitary, erythematous, subcutaneous nodule on the right knee. The clinical impression was epidermal cyst, and the resected tumor demonstrated a well-circumscribed mass in the dermis and subcutis. The tumor was composed of two regions: a solid component and a cribriform component. The solid component (90%) showed multiple solid nests of epithelial cells. Individual cells had large, oval-to-round, hyperchromatic, pleomorphic nuclei with a nuclear groove. The cribriform component (10%) showed similar neoplastic cells with many prominent lumina. Some lumina had an eosinophilic substance that exhibited a positive periodic acid-Schiff reaction. No recurrence or metastasis was observed within a follow-up period of eight months after excision. In conclusion, we report the first case of primary cribriform carcinoma of the skin in Korea.
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Affiliation(s)
- Hyun Lee
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong-Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan-Sik Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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19
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Menguy S, Jullié ML, Vergier B. Une tumeur annexielle reconnaissable. Ann Pathol 2020; 40:491-494. [DOI: 10.1016/j.annpat.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/09/2019] [Accepted: 05/12/2020] [Indexed: 10/23/2022]
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20
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Ferreira I, De Lathouwer O, Fierens H, Theunis A, André J, de Saint Aubain N. Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque. J Cutan Pathol 2020; 48:128-132. [PMID: 32918316 DOI: 10.1111/cup.13872] [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: 04/28/2020] [Revised: 08/26/2020] [Accepted: 08/31/2020] [Indexed: 11/26/2022]
Abstract
Adenomatoid tumors are benign tumors of mesothelial origin that are usually encountered in the genital tract. Although they have been observed in other organs, the skin appears to be a very rare location, with only one case reported in the literature to our knowledge. We report a second case of an adenomatoid tumor, arising in the umbilicus of a 44-year-old woman. The patient presented with an 8-month-old erythematous and firm plaque under the umbilicus. A skin biopsy showed numerous microcystic spaces dissecting a fibrous stroma and lined by flattened to cuboidal cells with focal intraluminal papillary formation. This little-known diagnosis constitutes a diagnostic pitfall for dermatopathologists and dermatologists, and could be misdiagnosed as other benign or malignant entities. Through this case report, a practical approach and diagnostic keys have been devised to avoid misdiagnosis and overtreatment.
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Affiliation(s)
- Ingrid Ferreira
- Dermatopathology laboratory, Department of Dermatology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier De Lathouwer
- Department of Plastic Surgery, Centre Hospitalier Interrégional Edith Cavell, Brussels, Belgium
| | - Hugues Fierens
- Department of Dermatology, Saint-Jean Hospital, Brussels, Belgium
| | - Anne Theunis
- Dermatopathology laboratory, Department of Dermatology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Josette André
- Dermatopathology laboratory, Department of Dermatology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas de Saint Aubain
- Department of Pathology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
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21
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Unusual Presentations of Primary and Metastatic Adenoid Cystic Carcinoma Involving the Skin. Am J Dermatopathol 2020; 42:967-971. [PMID: 32618709 DOI: 10.1097/dad.0000000000001730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adenoid cystic carcinoma (ACC) is most commonly seen in the salivary glands but may occur at other sites. Primary or metastatic involvement of the skin is unusual. We report 2 cases of ACC with unusual presentation. In the first case, a 55-year-old woman presented with a cutaneous lesion on the right shin, and final pathology showed ACC. An extracutaneous origin was excluded by clinical and imaging studies. In the second case, a 49-year-old woman presented with a nodule on the breast, and biopsy confirmed high-grade ACC (>30% solid areas). She underwent lumpectomy and subsequent mastectomy after recurrence. Sixteen months after the initial diagnosis of ACC of the breast, distant metastases at multiple sites, including the skin, were identified. This report will increase awareness of these rare presentations of cutaneous ACC and allow correct diagnosis and appropriate management of such cases.
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Affiliation(s)
| | - Desmond Shipp
- Department of Medicine, Division of Dermatology, The Ohio State University, Columbus, Ohio
| | - Catherine G Chung
- Department of Medicine, Division of Dermatology, The Ohio State University, Columbus, Ohio.,Department of Pathology, The Ohio State University, Columbus, Ohio
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23
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Do not break a sweat: avoiding pitfalls in the diagnosis of sweat gland tumors. Mod Pathol 2020; 33:25-41. [PMID: 31558783 DOI: 10.1038/s41379-019-0377-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 01/01/2023]
Abstract
The group of malignant sweat gland neoplasms is characterized by a wide biologic spectrum, including tumors with indolent behavior, low-grade malignant potential with locally destructive tumor growth and high local recurrence rates and high-grade malignant potential characterized by risk for disseminated disease and disease-related mortality. Reliable diagnosis to predict behavior may be challenging for a number of reasons. The clinical presentation is often nonspecific. Many of the tumors are rare, and they are only infrequently encountered in routine diagnostic practice. A significant subset of tumors shows bland and innocuous histologic features. They are easily mistaken for benign tumors despite their potential for destructive growth and aggressive disease course. At the other end of the spectrum the tumors may resemble poorly differentiated carcinoma or adenocarcinoma and recognition relies entirely on sampling and carful histological examination. The tumors may be inseparable from cutaneous metastases from visceral primaries by morphology and immunohistochemistry, requiring careful clinical correlation and work-up. Conversely, cutaneous metastases are readily mistaken for cutaneous primary tumors. While the presence of a myoepithelial layer is a helpful feature in excluding metastatic deposits, it does not imply benign behavior of sweat gland tumors in general. The above issues and challenges are exemplified in the discussion of selected sweat gland carcinoma in this manuscript, with a focus on recently described entities and those with novel findings.
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Craig PJ. An Overview of Uncommon Cutaneous Malignancies, Including Skin Appendageal (Adnexal) Tumours and Sarcomas. Clin Oncol (R Coll Radiol) 2019; 31:769-778. [PMID: 31466845 DOI: 10.1016/j.clon.2019.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 06/07/2019] [Accepted: 07/23/2019] [Indexed: 01/25/2023]
Abstract
A standardised classification of malignant skin appendageal (adnexal) tumours and sarcomas is required for improved patient management and prognosis. This has been hindered by considerable morphological variation both within and between tumour types, the use of many synonyms for the same tumour types and variation in classification between pathologists. This update uses the improved classification in the 2018 WHO classification of skin tumours as the basis to discuss malignant skin appendageal tumours, sarcomas and cutaneous metastases that regularly present to skin cancer clinicians, multidisciplinary skin cancer teams and tumour boards, with current evidence for management, where appropriate.
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Affiliation(s)
- P J Craig
- Gloucestershire Cellular Pathology Laboratory, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham General Hospital, Cheltenham, UK.
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Hayashi M, Yaguchi Y, Okamura K, Hemmi A, Abe Y, Takahashi H, Kato T, Ansai SI, Yamakawa M, Suzuki T. Primary Cutaneous Adenoid Cystic Carcinoma Connecting to the Epidermis. Am J Dermatopathol 2019; 41:619-621. [PMID: 31335423 DOI: 10.1097/dad.0000000000001179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | | | | | - Tomoya Kato
- Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shin-Ichi Ansai
- Division of Dermatology and Dermatopathology, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Japan
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DeCoste R, Moss P, Boutilier R, Walsh NM. Bowen disease with invasive mucin‐secreting sweat gland differentiation: Report of a case and review of the literature. J Cutan Pathol 2019; 46:425-430. [DOI: 10.1111/cup.13437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/03/2019] [Accepted: 02/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Ryan DeCoste
- Department of Pathology and Laboratory MedicineNova Scotia Health Authority, Central Zone (Halifax) Halifax Nova Scotia Canada
- Department of PathologyDalhousie University Halifax Nova Scotia Canada
| | - Phillip Moss
- Department of Pathology and Laboratory MedicineNova Scotia Health Authority, Central Zone (Halifax) Halifax Nova Scotia Canada
- Department of PathologyDalhousie University Halifax Nova Scotia Canada
| | - Robert Boutilier
- Department of Pathology and Laboratory MedicineNova Scotia Health Authority, Northern Zone (Truro) Halifax Nova Scotia Canada
| | - Noreen M.G. Walsh
- Department of Pathology and Laboratory MedicineNova Scotia Health Authority, Central Zone (Halifax) Halifax Nova Scotia Canada
- Department of PathologyDalhousie University Halifax Nova Scotia Canada
- Department of MedicineDalhousie University Halifax Nova Scotia Canada
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Wu JD, Changchien CH, Liao KS. Primary cutaneous cribriform apocrine carcinoma: Case report and literature review. Indian J Dermatol Venereol Leprol 2018; 84:569-572. [PMID: 29735815 DOI: 10.4103/ijdvl.ijdvl_830_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Primary cutaneous cribriform apocrine carcinoma is a rare but distinct variant of primary cutaneous apocrine carcinoma and it is considered a low grade malignancy. We herein present a case of primary cutaneous cribriform apocrine carcinoma at the neck of a 26-year-old female. The tumor features a relatively well-circumscribed border and multiple aggregations of mildly pleomorphic epithelial cells with large ovoid nuclei, small nucleoli and abundant eosinophilic cytoplasms. Cribriform and tubular structures are the major architectural patterns. The primary differential diagnosis is cutaneous metastasis from a cribriform visceral carcinoma; others include primary secretory carcinoma of the skin, adenoid cystic basal cell carcinoma and primary cutaneous adenoid cystic carcinoma.
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Affiliation(s)
- Jiann-Der Wu
- Department of Pathology, Health Sciences and Management, Chiayi, Taiwan
| | - Chih-Hsuan Changchien
- Department of Surgery, Chia-Yi Christian Hospital, Health Sciences and Management, Chiayi, Taiwan
| | - Kai-Sheng Liao
- Department of Pathology; Department of Nursing, Chung-Jen College of Nursing, Health Sciences and Management, Chiayi, Taiwan
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28
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Primary cutaneous adenoid cystic carcinoma: A clinical and histopathological mimic: A case report. ORAL AND MAXILLOFACIAL SURGERY CASES 2018. [DOI: 10.1016/j.omsc.2018.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Bao Y, Li J, Zhu Y. Mammary Analog Secretory Carcinoma With ETV6 Rearrangement Arising in the Conjunctiva and Eyelid. Am J Dermatopathol 2018; 40:531-535. [PMID: 29251639 DOI: 10.1097/dad.0000000000001062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mammary analog secretory carcinoma (MASC) of salivary gland is a recently described neoplasm that morphologically and immunohistochemically resembles secretory carcinoma of the breast. Genetically, both of them harbor ETV-6-NTRK-3 fusion rearrangement. One case of primary MASCs arising from the eyelid is reported. The patient was a 52-year-old man. Microscopically, the tumor exhibited nodular aggregation of solid, tubular, and microcystic/macrocystic structures. Characteristic "colloid-like" eosinophilic secretory material was present within intraluminal spaces. Immunohistochemically, the tumor cells were positive for mammaglobin, S-100, STAT5a, vimentin, GCDFP-15, AE1/AE3, EMA, and CK7 and were negative for DOG-1, CK5/6, and SMA. A dual color break-apart fluorescence in situ hybridization probe identified rearrangement of the ETV6 gene locus on chromosome 12. The patient had no history of breast or salivary gland tumor. The tumor was completely excised, and the patient has no evidence of recurrent disease or metastasis after 1-year follow-up. A diagnosis of primary MASC was rendered. MASC has never been reported occurring in ocular region. This type of secretory carcinoma probably originates from sweat glands or accessory lacrimal glands, Wolfring and Krause. This unique case expands the clinicopathologic landscape of MASCs for better characterization of this rare entity.
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Affiliation(s)
| | - Jiang Li
- Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Llamas-Velasco M, Pérez-Gónzalez YC, Daudén E, Rütten A. GATA3 staining in primary cutaneous apocrine cribriform carcinoma: Usefulness to differentiate it from breast cancer metastasis. J Cutan Pathol 2018; 45:348-351. [PMID: 29431200 DOI: 10.1111/cup.13124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/29/2018] [Accepted: 02/06/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Primary cutaneous apocrine cribriform carcinoma (PCACC) is a rare tumor, clinically appearing as a solitary nodule, mostly involving extremities of females and this lesion usually raises a differential diagnosis with metastatic cribriform carcinomas, especially breast cancer. OBJECTIVE To study GATA3 expression in a series of 14 primary cutaneous cribriform carcinomas and to test its usefulness to differentiate this tumor from metastatic breast cancer. METHODS We retrieved 14 cases with PCACC (each from a different patient) from the files of the authors. Cases were dated from 1994 to 2014. We also evaluated 6 cases of cutaneous breast cancer metastasis RESULTS: No PCACCs expressed GATA3. Breast cancer metastases expressed GATA3 in 100% of our studied cases. CONCLUSION Even though GATA3 expression has been reported in many benign and malignant adnexal tumors (mostly of sebaceous, follicular, and apocrine differentiation), as well as in many other neoplasms, GATA3 staining to differentiate PCACC from skin breast cancer metastasis has a high negative predictive value. A positive GATA3 staining in this context should permit one to rule out PCACC with a high level of confidence.
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Affiliation(s)
- Mar Llamas-Velasco
- Department of Dermatology, Instituto de Investigación Sanitaria (IIS-IP) Hospital Universitario de La Princesa, Madrid, Spain
| | - Yosmar C Pérez-Gónzalez
- Pathology Department, Fundación Jimenez Diaz, Madrid, Spain.,Dermatopathology Department, Centro Médico Voth, Madrid, Spain
| | - Esteban Daudén
- Department of Dermatology, Instituto de Investigación Sanitaria (IIS-IP) Hospital Universitario de La Princesa, Madrid, Spain
| | - Arno Rütten
- Dermatopathology Department, Dermatopathologie Friedrichshafen, Friedrichshafen, Germany
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Llamas-Velasco M, Mentzel T, Rütten A. Primary cutaneous secretory carcinoma: A previously overlooked low-grade sweat gland carcinoma. J Cutan Pathol 2018; 45:240-245. [PMID: 29205457 DOI: 10.1111/cup.13092] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Twelve cases of primary cutaneous secretory carcinoma (PCSC) have been published, 9 showing ETV6-NTRK3 translocation, a characteristic finding shared with secretory breast carcinoma and mammary analogue secretory carcinoma. CASE REPORT A 34-year-old female presented a solitary nodule on the right groin. Biopsy revealed a secretory carcinoma staining positive with CK7, CAM5.2, mammaglobulin and S100 and negative with GATA3, CK20, podoplanin, calponin and CDX2. ETV6-NTRK3 was demonstrated by Fluorescence in situ hybridization (FISH). DISCUSSION PCSC is a rare neoplasm, described in the skin in 2009, that affects more frequently females with a mean age of 42.3 years and it is most commonly located in axilla. Histopathologically, these tumor cells are characterized by bubbly eosinophilic secretions diastase-resistant and bland nuclei and they are arranged in various growth patterns, including microcystic, tubular, solid and papillary. S100, mammoglobin and CK7 are usually positive. We review the main histopathological features to rule out histopathologic mimics such as breast metastasis, salivary tumors, cribriform carcinoma and primary cutaneous adenoid cystic carcinoma. GATA3 negative staining, as in our case, can help to rule out breast metastasis. Moreover, long-term benign follow up (144 months) in this case as well as follow-up data on outcomes from literature review support that PCSC is a low-grade sweat gland carcinoma.
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Affiliation(s)
- Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Thomas Mentzel
- Friedrichshafen Dermatopathologie, Friedrichshafen, Germany
| | - Arno Rütten
- Friedrichshafen Dermatopathologie, Friedrichshafen, Germany
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Secretory Carcinoma of the Skin Harboring ETV6 Gene Fusions: A Cutaneous Analogue to Secretory Carcinomas of the Breast and Salivary Glands. Am J Surg Pathol 2017; 41:62-66. [PMID: 27631515 DOI: 10.1097/pas.0000000000000734] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mammary analogue secretory carcinoma is a low-grade salivary gland carcinoma that exhibits analogous features to secretory carcinoma of the breast including the presence of a t(12;15) translocation resulting in the ETV6-NTRK3 gene fusion. Rare cases of purported secretory carcinoma of the skin adnexa have been reported, but their relationship to true secretory carcinoma of the breast and salivary glands is unclear, as they generally do not harbor ETV6 rearrangements. Cases of cutaneous neoplasms with histologic features identical to secretory carcinoma of the breast and salivary glands were identified from the consultation files of 3 academic medical institutions. Immunohistochemistry was performed for S100 protein, mammaglobin and STAT5a. Break-apart fluorescence in situ hybridization was used evaluate for disruption of the ETV6 gene. Six cases of cutaneous secretory carcinoma were identified. The tumors arose in 4 women and 2 men, ranging from 24 to 71 years in age (mean, 47 y). The carcinomas presented in the skin of the axilla (n=4), ventral neck (n=1), and cheek (n=1). The tumors arose in the superficial dermis in association with adnexal structures. None of the patients had a prior or concurrent breast or salivary gland tumor. They were histologically characterized by well-circumscribed but unencapsulated proliferations of bland, eosinophilic cells arranged in microcysts and follicles with intraluminal secretions. Ectopic breast or salivary gland tissue was not identified. The cases were diffusely positive for S100 protein (6 of 6), mammaglobin (6 of 6), and STAT5a (5 of 5). All 6 cases harbored rearrangements of ETV6. All tumors were treated by simple excision alone. No recurrences or metastases developed in the 2 cases with follow-up. Secretory carcinoma of the skin represents a phenotypic, immunohistochemical, and genetic counterpart to secretory carcinoma of the breast and salivary glands. This tumor entity is less anatomically restricted than previously supposed.
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"Secretory" Carcinoma of the Skin Mimicking Secretory Carcinoma of the Breast: Case Report and Literature Review. Am J Dermatopathol 2017; 38:698-703. [PMID: 26981741 DOI: 10.1097/dad.0000000000000566] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Secretory carcinoma is a unique kind of adenocarcinoma. It has distinct histological features and a special genetic change, that is, t (12; 15) (p13; q25) translocation which leads to the expression of the ETV6-NTRK3 fusion gene. Secretory carcinoma has been found to occur both in the breast and salivary gland. Here the authors present a case of 22-year-old woman with a unique cutaneous neoplasm located at the axilla. The tumor was characterized histologically with the formation of round to ovoid microcysts and papillary structure, which was similar to the secretory carcinoma of the breast and salivary gland. Furthermore, the gene sequence analysis of reverse-transcription polymerase chain reaction products demonstrated the expression of the ETV6-NTRK3 fusion gene. To the authors' knowledge, this is the first case of secretory carcinoma from the skin which has the same genetic change as those from the breast and salivary gland. Local excision was performed on this patient. She had been followed up for nearly 1 year. No recurrence or metastasis was found yet.
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36
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Two Different Cell Populations Is an Important Clue for Diagnosis of Primary Cutaneous Adenoid Cystic Carcinoma: Immunohistochemical Study. Case Rep Pathol 2017; 2017:7949361. [PMID: 28243477 PMCID: PMC5294388 DOI: 10.1155/2017/7949361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 12/08/2016] [Indexed: 11/17/2022] Open
Abstract
Primary cutaneous adenoid cystic carcinoma (PCACC) is a very rare malignancy. The differential diagnosis of PCACCs in pathology practice can be difficult and a group of primary and metastatic lesions, including adenoid basal cell carcinoma of the skin, should be considered in the differential diagnosis. Besides histomorphological clues, immunohistochemistry studies are very helpful in the differential diagnosis of PCACC. We report herein a case of PCACC with extensive immunohistochemical studies and review the literature from an immunohistochemistry perspective.
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Prieto-Granada CN, Zhang L, Antonescu CR, Henneberry JM, Messina JL. Primary cutaneous adenoid cystic carcinoma with MYB aberrations: report of three cases and comprehensive review of the literature. J Cutan Pathol 2016; 44:201-209. [PMID: 27859477 DOI: 10.1111/cup.12856] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 12/28/2022]
Abstract
Adenoid cystic carcinoma (ACC) is a relatively rare slow-growing and often-aggressive epithelial-myoepithelial neoplasm that arises in multiple organs including the skin. The t(6;9) (q22-23;p23-24) translocation, resulting in a MYB-NFIB gene fusion has been found in ACCs from the salivary glands and other organs. Recently, MYB aberrations occurring in a subset (40%) of primary cutaneous ACC (PCACC) examples was described. Herein, we report three additional cases of PCACC harboring MYB aberrations. The tumors presented in three males aged 43, 81 and 55 years old and affected the extremities in the first two patients and the scalp in the third one. None of the patients had history of prior or concurrent ACC elsewhere. Lesions exhibited the classic ACC morphology of nests of basaloid cells arranged in cribriform and adenoid patterns. Sentinel lymph node biopsy was performed in two cases with one case showing lymph node positivity. Fluorescence in situ hybridization with break-apart probes for MYB and NFIB loci revealed that two cases showed MYB rearrangements while one case showed loss of one MYB signal. None of the cases showed NFIB rearrangements. We contribute with three additional cases of PCACC exhibiting MYB aberrations, the apparent driving genetic abnormality in these tumors.
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Affiliation(s)
| | - Lei Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA
| | - Cristina R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA
| | - Jean M Henneberry
- Department of Pathology, Baystate Medical Center, Springfield, MA, USA
| | - Jane L Messina
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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[Primary cutaneous cribriform apocrine carcinoma : An underdiagnosed entity?]. Hautarzt 2016; 67:750-2. [PMID: 27270583 DOI: 10.1007/s00105-016-3811-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Primary cutaneous cribriform apocrine carcinoma is a distinctive but little known variant of cutaneous apocrine carcinoma with indolent biological behaviour. It should not be mistaken for a cutaneous metastasis of a visceral carcinoma, an adenoid cystic basal cell carcinoma or a primary cutaneous adenoid cystic carcinoma.
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Affiliation(s)
- José C. Cardoso
- Dermatology Department; Coimbra Hospital and University Centre; Coimbra Portugal
| | - Eduardo Calonje
- Dermatopathology Department; St John's Institute of Dermatology; London UK
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Li Y, Chen LL, Li B, Tian XY, Li Z. Unusual apocrine carcinoma with neuroendocrine differentiation: a cutaneous neoplasm may be analogous to neuroendocrine carcinoma with apocrine differentiation of breast. Diagn Pathol 2015; 10:64. [PMID: 26055980 PMCID: PMC4460766 DOI: 10.1186/s13000-015-0302-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/22/2015] [Indexed: 11/22/2022] Open
Abstract
Cutaneous apocrine carcinoma (AC) is a rare adnexal neoplasm that histologically can mimic breast carcinoma metastatic to the skin or apocrine carcinoma arising in ectopic breast tissue. As extremely rare condition, neuroendocrine differentiation may be observed in AC although its etiology and pathogenesis is still unclear. We report here a case of unusual AC with neuroendocrine differentiation in right labium majus pudenda. A 43-year-old woman presented with a 6-month history of an asymptomatic pea-sized brownish nodule in right labium majus pudenda without enlargement of inguinal lymph nodes and bilateral breast nodules. The mass was totally resected. Microscopically, the tumor was solitary and located in the deep dermis without epidermal connection. Tumor cells were arranged in a micronodular or formed massive solid nests separated by densely fibroblastic stroma. Scattered glandular or rosette-like structures were identified within the tumor nodules. Immunohistochemically, the tumor cells were diffusely positive to CK7, CEA, GCDFP-15, synaptophysin, estrogen and progesterone receptors. Part of tumor cells expressed androgen receptor, but they were negative to CK20, CK5/6, p63 and S-100. Because of its rarity and histogenesis complexity, there exist diagnostic challenges for pathologists to differentiate cutaneous AC with neuroendocrine differentiation from other carcinomas with apocrine or neuroendocrine features. Our case demonstrates that the tumor shares some features with mammary carcinoma and might originate from mammary-like sweat gland in anogenital region. The results suggest that, for the first time, primary cutaneous AC with neuroendocrine differentiation may be analogous to the mammary neuroendocrine carcinoma with apocrine differentiation in histological feature and biological behavior. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7732276716685708.
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Affiliation(s)
- Yang Li
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, 58, Zhongshan Road II, Guangzhou, 510080, China
| | - Li-li Chen
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, 58, Zhongshan Road II, Guangzhou, 510080, China
| | - Bin Li
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, 58, Zhongshan Road II, Guangzhou, 510080, China
| | - Xiao-ying Tian
- School of Chinese Medicine, Hong Kong Baptist University, 7, Baptist University Road, Kowloon Tong, Hong Kong, China
| | - Zhi Li
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, 58, Zhongshan Road II, Guangzhou, 510080, China.
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Choi IH, Yun S. Large cutaneous apocrine carcinoma occurring on right thigh aggravated after moxa treatment. Ann Surg Treat Res 2015; 88:294-7. [PMID: 25960994 PMCID: PMC4422884 DOI: 10.4174/astr.2015.88.5.294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 10/10/2014] [Accepted: 10/15/2014] [Indexed: 11/30/2022] Open
Abstract
Primary cutaneous apocrine carcinoma is a rare adnexal tumor of the skin that occurs mainly in the axilla, anogenital area while the scalp and the lower extremities, especially the thigh, are very unusual sites. However, clinical or pathologic characteristics have not been well established due to a paucity of this tumor. Herein, we report very unusual case of apocrine carcinoma present as a huge mass in the lateral thigh of 77-year-old woman, which was aggravated abruptly after an irritation by moxa treatment, with a brief review of the literature.
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Affiliation(s)
- In Ho Choi
- Department of Pathology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sangchul Yun
- Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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42
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Arps DP, Chan MP, Patel RM, Andea AA. Primary cutaneous cribriform carcinoma: report of six cases with clinicopathologic data and immunohistochemical profile. J Cutan Pathol 2015; 42:379-87. [DOI: 10.1111/cup.12469] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/14/2015] [Accepted: 02/16/2015] [Indexed: 11/28/2022]
Affiliation(s)
- David P. Arps
- Department of Pathology; University of Michigan; Ann Arbor MI USA,
| | - May P. Chan
- Department of Pathology; University of Michigan; Ann Arbor MI USA,
- Department of Dermatology; University of Michigan; Ann Arbor MI USA
| | - Rajiv M. Patel
- Department of Pathology; University of Michigan; Ann Arbor MI USA,
- Department of Dermatology; University of Michigan; Ann Arbor MI USA
| | - Aleodor A. Andea
- Department of Pathology; University of Michigan; Ann Arbor MI USA,
- Department of Dermatology; University of Michigan; Ann Arbor MI USA
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Evaluation of an anal sac adenocarcinoma tumor in a Spitz dog. Asian Pac J Trop Biomed 2013; 3:74-8. [PMID: 23570021 DOI: 10.1016/s2221-1691(13)60027-1] [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: 10/10/2012] [Accepted: 12/20/2012] [Indexed: 11/22/2022] Open
Abstract
A 9-year-old emasculated male Spitz with tenesmus and constipation had a subcutaneous mass at the left ventral aspect of the anus with history of polyuria and polydipsia. A complete blood cell count, serum biochemistry panel, and urinalysis (cystocentesis sample) were evaluated. Abnormalities in the serum biochemistry panel included a mildly elevated serum cholesterol concentration (7.28 mmol/L; reference interval, 2.70-5.94 mmol/L), increased serum alkaline phosphatase activity (184 U/L; reference interval, 9-90 U/L), alanine transaminase (122 U/L; reference interval, 5-60 U/L) activity and aspartate aminotransferase (80 U/L; reference interval, 5-55 U/L) activity, severe increased total calcium concentration (16.3 mg/dL; reference interval, 8.2-12.4 mg/dL or 9.3-11.4 mg/dL), and decreased total calcium concentration (3.4 mg/dL, reference interval, 2.5-5.6mg/dL). Furthermore, testing revealed an increased intact parathyroid hormone concentration (38.6 pmol/L; reference interval, 3-17 pmol/L). On cytologic and histopathologic examinations, various types of cells were observed. Most of the cells were oval to polygonal and had elliptical or elongate nuclei and a moderate amount of pale to basophilic cytoplasm. The remaining cells had round to oval nuclei and pale to basophilic cytoplasm. Cells of both types were loosely adhered to each other and were arranged in rosette-like structures. Both neoplastic cell types had fine homogenous chromatin and either a small indistinct nucleolus or no visible nucleolus. Mild anisokaryosis and anisocytosis were observed. Histologically, the mass consists of glandular structures formed by cuboidal cells admixed with bundles of spindle cells. Based on location and histologic features, the final diagnosis was adenocarcinoma of the apocrine gland of the anal sac, which should be included as a cytologic differential diagnosis when spindle cells and typical epithelial cells are observed in masses in the region of the anal sac of dogs.
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Machado I, Traves V, Cruz J, Llombart B, Navarro S, Llombart-Bosch A. Superficial small round-cell tumors with special reference to the Ewing's sarcoma family of tumors and the spectrum of differential diagnosis. Semin Diagn Pathol 2013; 30:85-94. [DOI: 10.1053/j.semdp.2012.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Secrest AM, Seethala RR, Ferris LK, Sam H. Cutaneous apocrine carcinoma masquerading as head and neck cellulitis: an ominous sign. ACTA ACUST UNITED AC 2011; 147:1335-7. [PMID: 22106132 DOI: 10.1001/archdermatol.2011.349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Ogawa B, Taniai E, Hayashi H, Imaoka M, Machida N, Mitsumori K, Shibutani M. Neuroendocrine carcinoma of the apocrine glands of the anal sac in a dog. J Vet Diagn Invest 2011; 23:852-6. [PMID: 21908338 DOI: 10.1177/1040638711407884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A perianal subcutaneous tumor involving the anal sac developed in an 8-year-old male mixed Labrador Retriever dog. Histologically, this tumor showed typical features of the solid-type carcinoma of the apocrine glands of the anal sac. However, neoplastic cells were immunoreactive for cytokeratin 8, chromogranin A, vasoactive intestinal peptide, neuron-specific enolase, and synaptophysin, and negative for S-100 protein, α-smooth muscle actin, vimentin, glucagon, insulin, somatostatin, carcinoembryonic antigen, serotonin, and parathyroid hormone-related protein. Considering the distribution of chromogranin A-positive cells within the anal sac apocrine glands, this tumor was diagnosed as neuroendocrine carcinoma originating from the apocrine glands of the anal sac.
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Affiliation(s)
- Bunichiro Ogawa
- Laboratory of Veterinary Pathology, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
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Hollowell KL, Agle SC, Zervos EE, Fitzgerald TL. Cutaneous apocrine adenocarcinoma: defining epidemiology, outcomes, and optimal therapy for a rare neoplasm. J Surg Oncol 2011; 105:415-9. [PMID: 21913192 DOI: 10.1002/jso.22023] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 06/16/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Apocrine adenocarcinoma is a rare neoplasm. There is a paucity of data on demographics and survival with no clear consensus on management of at risk lymph nodes, therefore, we analyzed a large cohort of patients identified via a national tumor registry. METHODS Patients ages 17-91 from 1973 to 2006 were identified in the SEER registry and excluded breast and non-cutaneous neoplasms. Data analyzed included basic demographics, survival, surgical therapy, and stage. RESULTS A total of 186 patients with apocrine adenocarcinoma were identified. The median age was 67 years, 76% were white and there was an equal distribution of males and females. The most common site was trunk (53%) followed by head and neck (35%). Surgery was performed on most patients (96%), either excision (50%) or wide excision (30%). Lymph node metastases were present in 69% patients undergoing node surgery. Median overall survival was 51.5 months. Positive lymph node status (P = 0.006) and metastatic disease (P < 0.001) were associated with diminished overall survival. CONCLUSIONS Cutaneous apocrine adenocarcinoma is a rare neoplasm. Excision is standard treatment. The most important predictor of survival in localized disease is lymph node status; therefore, sentinel lymph node biopsy could be considered in management of this disease.
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Affiliation(s)
- Kerry L Hollowell
- Division of Surgical Oncology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
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Kazakov DV, Plaza JA, Suster S, Kacerovska D, Michal M. Cutaneous cribriform carcinoma: a short comment. J Am Acad Dermatol 2011; 64:599-601. [PMID: 21315957 DOI: 10.1016/j.jaad.2010.06.065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 06/21/2010] [Accepted: 06/30/2010] [Indexed: 11/15/2022]
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Cacchi C, Persechino S, Fidanza L, Bartolazzi A. A primary cutaneous adenoid-cystic carcinoma in a young woman. Differential diagnosis and clinical implications. Rare Tumors 2011; 3:e3. [PMID: 21464876 PMCID: PMC3070451 DOI: 10.4081/rt.2011.e3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 12/06/2010] [Accepted: 12/16/2010] [Indexed: 11/23/2022] Open
Abstract
Primary cutaneous adenoid-cystic carcinoma (PCACC) is a rare slow-growing neoplasm of disputed histogenesis characterized by a cribriform pattern at histology and local aggressive behaviour. Up to date about 60 cases of PCACC have been reported in the literature. This tumour is most common in the scalp, affects middle-aged and older individuals (mean age 59) and has predilection for women. We describe an unexpected case of PCACC in a 32-years-old woman referred to our clinic for a subcutaneous nodule in the scalp showing a slow growth and indolent course. The differential diagnosis and the clinical management of this PCACC patient, successfully treated with a wide local excision, are presented and discussed.
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Affiliation(s)
- Claudio Cacchi
- Pathology Unit, Sant'Andrea University Hospital, Rome, Italy
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