Primary mucinous carcinoma of the skin arising from the upper eyelid: A case report and literature review

Primary Mucinous Carcinoma of Skin: A Rare Cutaneous Neoplasm. Clinicopathologic Features, Differential Diagnoses, and Review of Literature

ABSTRACT

Primary mucinous carcinoma of the skin (PMCS) is a rare malignant neoplasm of sweat gland origin, with an incidence of 0.07 per million. Histologically, it may be difficult to differentiate it from metastatic mucinous carcinomas of the skin. A case of PMCS is reported here in a 59-year-old woman who presented with a lesion on the right lower eyelid. Histological examination revealed features of mucinous adenocarcinoma. The main differential diagnosis was metastatic mucinous adenocarcinoma; however, the lack of colorectal and lung markers and the presence of focal in situ components were consistent with the diagnosis of PMCS. PMCS and breast mucinous carcinoma share immunohistochemical markers, such as GCDFP-15 and mammaglobin; however, focal in situ component with the presence of myoepithelial cells in the tumor ruled out metastatic mucinous carcinoma of breast origin. The subsequent mammograms did not reveal any breast lesions. Colonoscopy did not show any evidence of colonic malignancy, and imaging studies (CT scan) did not show any evidence of neoplasm in the body. These findings were in keeping with a diagnosis of PMCS. The present case emphasizes the importance of clinicopathological correlation, histopathology, and immunohistochemistry in the accurate diagnosis of PMCS and summarizes the literature on these rare cutaneous neoplasms.

Primary cutaneous mucinous carcinoma of the scalp masquerading as a benign dermatological mass - A case report

INTRODUCTION AND IMPORTANCE

Primary cutaneous mucinous carcinoma (PCMC) is a rare low-grade malignant neoplasm derived from the sweat glands. Local recurrence of PCMC occurs frequently, but these lesions rarely metastasize. Due to the absence of classical demographic and clinical characteristics, PCMCs masquerade as sebaceous cyst, lipoma, pilomatrixoma, chalazion, or squamous cell carcinoma. This misdiagnosis frequently leads to incomplete surgical excision which necessitates further surgical therapy for a curative intent.

CASE PRESENTATION

We present a case of PCMC in a 45-year-old woman which presented as a slow- growing and symptomless nodule in the scalp. After clinical evaluation, the patient had a typical surgical excision for a benign-looking lesion. Histological evaluation of the specimen confirmed a localized PCMC in the scalp with involved surgical margins.

CLINICAL DISCUSSION

A thorough oncological assessment by PET-CT scan and radionuclide scintigraphy was performed. Later, a wide local excision using a gamma probe for intra-operative radionuclide localization of the tumor area and sentinel lymph nodes was done.

CONCLUSION

The patient did not have any regional or distant metastases and remained stable at the time of reporting this case.

A rare case of primary adenocarcinoma of the eyelid

Introduction. primary mucinous carcinoma of the eyelid skin is a rare adenocarcinoma of skin glands. This tumor rarely metastasizes but frequently recurs.

The study objective is to describe a rare clinical case of primary mucinous carcinoma of the eyelid skin, present macroscopic, histological and immunohistological descriptions of this pathology.

Clinical case. male, 66 years old, sought medical care due to a neoplasm of the lower eyelid. macroscopically a subcutaneous node 1.2 × 1.0 cm was observed, of yellow-brown color, gelatinous in section. microscopic examination showed that the tumor consists of islands of epithelial cells surrounded by mucinous “lakes”. Immunohistochemical examination showed Ck7, estrogen, p53 expression in the tumor cells, as well as absence of Ck20 expression. Based on the data of macro-, microscopic and immunohistochemical examinations, primary mucinous carcinoma of the eyelid skin was diagnosed. Observed morphological signs of this tumor allow to differentiate it from cancer metastasis.

Conclusion. primary mucinous carcinoma of the skin should be differentiated from metastasis of mucinous carcinoma of the breast, lung, colon, et al. macro- and microscopic signs of this tumor are subjective. Immunohistochemical examination is a more reliable diagnostic tool.