1
|
Wagner K, Jassal K, Lee JC, Ban EJ, Cameron R, Serpell J. Challenges in diagnosis and management of a spiradenocarcinoma: a comprehensive literature review. ANZ J Surg 2021; 91:1996-2001. [PMID: 33522696 DOI: 10.1111/ans.16626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Spiradenocarcinoma is a rare skin adnexal neoplasm that may behave aggressively. It is often associated with a benign slow-growing spiradenoma that has undergone malignant transformation. Given the paucity of cases in the literature, there is a lack of consensus on treatment. METHODS The terms 'malignant spiradenoma' or 'spiradenocarcinoma' were systematically used to search the PubMed, MEDLINE and Google Scholar databases. A total of 182 cases of spiradenocarcinoma were identified as eligible for this comprehensive literature review. RESULTS Spiradenocarcinoma was commoner in older age and Caucasian race. In most cases, surgical excision for local disease is the mainstay of treatment. Lymph node dissection is usually reserved for those with suspected or confirmed lymph node metastases. High rates of local recurrence (20.8%), metastasis (37.4%) and mortality (19.1%) were identified, prompting some authors to suggest regular follow up including chest X-rays and liver function tests. CONCLUSIONS Patients with spiradenocarcinoma may benefit from a magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography/computed tomography to establish the extent of disease. We recommend wide local excision as the treatment of choice to achieve surgical margins of ≥1 cm, with node resection to be determined on a case-to-case basis. Regular follow up is important given the high rate of local recurrence, metastasis and mortality. This should include an examination of the regional lymph nodes. Further research is required to refine an evidence-based approach to spiradenocarcinoma.
Collapse
Affiliation(s)
- Katy Wagner
- Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia
| | - Karishma Jassal
- Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia
| | - James C Lee
- Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Ee-Jun Ban
- Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Rhoda Cameron
- Department of Pathology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Jonathan Serpell
- Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Held L, Ruetten A, Saggini A, Kempter W, Tiedke C, Weber-Kuhn S, De Saint Aubain N, Mentzel T. Metaplastic spiradenocarcinoma: Report of two cases with sarcomatous differentiation. J Cutan Pathol 2020; 48:384-389. [PMID: 33051901 DOI: 10.1111/cup.13897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/20/2020] [Accepted: 10/05/2020] [Indexed: 01/09/2023]
Abstract
Spiradenocarcinoma (SC) is a very rare malignant skin adnexal tumor with sweat gland differentiation that develops from a pre-existing spiradenoma, cylindroma, or hybrid tumor called spiradenocylindroma, or arises de novo. We present two exceptionally rare SC cases showing sarcomatous differentiation; we also discuss the clinicopathologic features of SC, as well as its differential diagnoses and available therapeutic modalities. Given the aggressive behavior of SC, rapid diagnosis and complete removal of the tumor with tumor-free margins is mandatory. Owing to the marked morphological heterogeneity of individual SC cases, dermatopathologists must be familiar with the different possible histopathologic manifestations of this neoplasm.
Collapse
Affiliation(s)
- Laura Held
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Arno Ruetten
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Andrea Saggini
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - Carmen Tiedke
- Centre of Orthopedic and Trauma Surgery, Department of Oncologic Surgery, Sarcoma Centre Berlin, Brandenburg, Berlin, Germany
| | - Susanne Weber-Kuhn
- Pathology Department, MVZ am Helios Klinikum Emil von Behring, Berlin, Germany
| | | | - Thomas Mentzel
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| |
Collapse
|
3
|
Jones KJ, Jariwala N, Cusack CA. Spiradenocylindroma: an uncommon morphologic entity. Int J Dermatol 2016; 55:801-3. [PMID: 26946339 DOI: 10.1111/ijd.13233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 10/28/2015] [Accepted: 11/04/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Krister J Jones
- Department of Dermatology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Neha Jariwala
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Carrie A Cusack
- Department of Dermatology, Drexel University College of Medicine, Philadelphia, PA, USA
| |
Collapse
|
4
|
Hayashi T, Haba R, Katsuki N, Kushida Y, Kadota K, Bando K, Moriue J, Yokoi I, Izumi M, Kubota Y. Low-grade cylindromatous adnexal carcinoma with unusual histopathological features: report of a case with comparative immunohistochemical study and meta-analysis of the literature. J Cutan Pathol 2015; 42:1000-1011. [PMID: 26269423 DOI: 10.1111/cup.12597] [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: 02/26/2010] [Revised: 12/21/2010] [Accepted: 05/23/2011] [Indexed: 11/26/2022]
Abstract
We present an extremely rare case of low-grade cylindromatous adnexal carcinoma (CAC) on the right chest wall of a 77-year-old man. Histopathologically, the neoplasm was initially diagnosed as a cylindroma that developed over the course of 13 years. A diagnosis of low-grade CAC was rendered after the documentation of a local recurrence and histopathology of the recurrent tumor. To further assess the evolution of low-grade CAC over time, we compared the morphology, mitotic account, proliferative markers and adhesion molecule immunoreactivity among paired primary and recurrent tumors. Unlike those earlier reported, our case showed the maintenance of tumor morphology after a recurrence without areas of obvious malignant transformation or metaplastic change. We showed here for the first time the expression of adhesion molecules of CAC/spiradenoma and a comparison of proliferation indices between a primary tumor and its local recurrence. This peculiar tumor differs from previously reported cases and harbors a malignant potential although the histopathological features of malignancy are subtle. Our meta-analysis of the literature provided background information regarding this rare entity. Alterations of E-cadherin and GCDFP-15 expression may provide additional helpful clues in differential diagnosis and determining the clinical behavior of this unusual neoplasm. Further studies are warranted to confirm the potential discriminative role of these markers.
Collapse
Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Reiji Haba
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Naomi Katsuki
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yoshio Kushida
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Kyuichi Kadota
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Kenji Bando
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Junko Moriue
- Department of Dermatology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Ikumi Yokoi
- Department of Dermatology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Miki Izumi
- Department of Diagnostic Pathology and Medical Education, Tokyo Medical University, Tokyo, Japan
| | - Yasuo Kubota
- Department of Dermatology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| |
Collapse
|
5
|
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
| |
Collapse
|
6
|
van der Horst MPJ, Marusic Z, Hornick JL, Luzar B, Brenn T. Morphologically low-grade spiradenocarcinoma: a clinicopathologic study of 19 cases with emphasis on outcome and MYB expression. Mod Pathol 2015; 28:944-53. [PMID: 25857824 DOI: 10.1038/modpathol.2015.48] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/03/2015] [Indexed: 01/18/2023]
Abstract
Spiradenocarcinoma is a rare skin adnexal neoplasm with potential for aggressive behavior, classified histologically into low- and high-grade tumors. Morphologically, low-grade tumors are thought to behave more favorably. Limited information is available, however, with only 18 published cases. To study their clinical behavior, histological features, and the diagnostic value of immunohistochemistry, 19 morphologically low-grade spiradenocarcinomas were retrieved and compared with 21 spiradenomas and cylindromas. H&E-stained sections were reviewed, follow-up was obtained, and immunohistochemistry for Ki-67, p53 and, MYB was performed. The tumors were solitary, measuring 0.8-7 cm (median: 2.7 cm), with a predilection for the head and neck of elderly patients (median age: 72 years; range 53-92) without gender bias. Histologically, the tumors were multinodular and located in deep dermis and subcutis. A pre-existing spiradenoma was present in all cases. The malignant component was characterized by expansile growth with loss of the dual cell population, up to moderate cytological atypia and increased mitotic activity (median: 10/10 HPF; range 1-28). Additional findings included squamoid differentiation (n=9), necrosis (n=7), and ulceration (n=5). P53 expression was variable and no significant differences were noted in the benign compared with the malignant parts of the tumors. In contrast, in the malignant components the Ki-67 proliferative index was slightly increased, and MYB expression was lost. Follow-up (median: 67 months; range: 13-132) available for 16 patients (84%) revealed a local recurrence rate of 19% but no metastases or disease-related mortality. In this large study with long-term follow-up, we demonstrate that spiradenocarcinomas with low-grade morphology pursue an indolent course, characterized by local recurrence only. Metastases and disease-related mortality appear to be exceptional. Lack of MYB expression may be useful as an additional aid in the diagnosis of these challenging tumors.
Collapse
Affiliation(s)
| | - Zlatko Marusic
- Clinical Hospital Center Sestre milosrdnice, Zagreb, Croatia
| | - Jason L Hornick
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Thomas Brenn
- Department of Pathology, Western General Hospital and The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
7
|
|
8
|
Borik L, Heller P, Shrivastava M, Kazlouskaya V. Malignant cylindroma in a patient with Brooke-Spiegler syndrome. Dermatol Pract Concept 2015; 5:61-5. [PMID: 26114054 PMCID: PMC4462901 DOI: 10.5826/dpc.0502a09] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/09/2015] [Indexed: 11/06/2022] Open
Abstract
Malignant cylindroma (cylindromatous carcinoma, cylindrocarcinoma) is the malignant counterpart of benign cylindroma. It is a rare neoplasm, more often developing in the setting of multiple preexisting benign neoplasms. Herein we present an additional case of malignant transformation of the cylindroma diagnosed in an 83-year-old patient with known Brooke-Spiegler syndrome.
Collapse
Affiliation(s)
- Liliane Borik
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria ; Ackerman Academy of Dermatopathology, New York, NY, USA
| | | | | | | |
Collapse
|
9
|
Petersson F, Nga ME. Spiradenocarcinoma with low-grade basal cell adenocarcinoma pattern: report of a case with varied morphology and wild type TP53. J Cutan Pathol 2011; 39:372-6. [DOI: 10.1111/j.1600-0560.2011.01810.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
10
|
Abstract
A 84-year-old-woman presented a painless eyelid mass in her right eyelid. A biopsy was made and the anatomopathologic study showed a spiradenoma with malignant changes. The patient rejected any kind of treatment in spite of the prognosis of the lesion. Radiological and pathological features of this infrequent eyelid tumour are discussed.
Collapse
Affiliation(s)
- Carlos Sevillano Torrado
- Department of Ophthalmology, Orbit and Oculoplastic Section, Hospital Complex of Pontevedra, Pontevedra, Spain.
| | | | | | | |
Collapse
|