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Torre-Castro J, Ríos-Viñuela E, Balaguer-Franch I, Díaz de Lezcano I, Aguado-García Á, Nájera L, Suárez D, Requena L. Perineural Infiltration: A Comprehensive Review of Diagnostic, Prognostic, and Therapeutic Implications. Am J Dermatopathol 2024; 46:271-286. [PMID: 38457673 DOI: 10.1097/dad.0000000000002667] [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: 03/10/2024]
Abstract
ABSTRACT Perineural infiltration refers to a neoplastic cell involvement in, around, and through the nerves. It is considered as one of the neoplastic dissemination pathways. Thus, its identification is crucial to establish the prognosis of some malignant skin neoplasms, such as squamous cell carcinoma, and explains the locally aggressive behavior of cutaneous neoplasms, such as microcystic adnexal carcinoma. We have conducted a review of malignant and benign skin tumors in which perineural infiltration has been described, and we also discuss some histopathological findings that may simulate perineural infiltration.
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Affiliation(s)
- Juan Torre-Castro
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, Escuela de Doctorado Universidad Católica de Valencia, Valencia, Spain
| | | | | | | | - Laura Nájera
- Department of Pathology, Puerta de Hierro University Hospital, Universidad Autónoma, Majadahonda, Madrid, Spain
| | - Dolores Suárez
- Department of Pathology, Puerta de Hierro University Hospital, Universidad Autónoma, Majadahonda, Madrid, Spain
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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Conte S, Ghezelbash S, Nallanathan B, Lefrançois P. Clinical and Molecular Features of Morpheaform Basal Cell Carcinoma: A Systematic Review. Curr Oncol 2023; 30:9906-9928. [PMID: 37999140 PMCID: PMC10670319 DOI: 10.3390/curroncol30110720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, with a lifetime risk currently approaching up to 40% in Caucasians. Among these, some clinical and pathological BCC variants pose a higher risk due to their more aggressive biological behavior. Morpheaform BCC (morBCC), also known as sclerosing, fibrosing, or morpheic BCC, represents up to 5-10% of all BCC. Overall, morBCC carries a poorer prognosis due to late presentation, local tissue destruction, tumor recurrence, and higher frequency of metastasis. In this systematic review, we review the epidemiological, clinical, morphological, dermatoscopical, and molecular features of morBCC. After the title and abstract screening of 222 studies and the full-text review of 84 studies, a total of 54 studies met the inclusion criteria and were thus included in this review.
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Affiliation(s)
- Santina Conte
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada;
| | - Sarah Ghezelbash
- Cancer Axis, Lady Davis Institute for Medical Research, Montreal, QC H3T 1E2, Canada; (S.G.); (B.N.)
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Bonika Nallanathan
- Cancer Axis, Lady Davis Institute for Medical Research, Montreal, QC H3T 1E2, Canada; (S.G.); (B.N.)
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Philippe Lefrançois
- Cancer Axis, Lady Davis Institute for Medical Research, Montreal, QC H3T 1E2, Canada; (S.G.); (B.N.)
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
- Division of Dermatology, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
- Division of Dermatology, Department of Medicine, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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3
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Bi Y, Shi X, Chen D, Zhao Y. CD133, but Not CD44, May Serve as a Novel Biomarker for Differential Diagnosis Between Basal Cell Carcinoma and Trichoblastomas. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1517-1526. [PMID: 35941854 PMCID: PMC9356750 DOI: 10.2147/ccid.s373331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/20/2022] [Indexed: 11/23/2022]
Abstract
Purpose To investigate the clinical value of CD133 and CD44 as putative cancer stem cell markers in distinguishing between basal cell carcinoma (BCC) and trichoblastomas (TB). Patients and Methods Tumor samples from 24 BCC and 23 TB patients were retrospectively retrieved for immunohistochemical staining of CD133 and CD44. The results were interpreted using a semiquantitative scoring system (H score). A receiver operating characteristic (ROC) curve was developed to identify an optimal cutoff value for differentiating between BCC and TB. Results Expression of CD133 was significantly higher in BCC patients than in TB patients (median H score: 30 [IQR: 12.5–56.3] vs 0 [IQR: 0–2], P < 0.001). However, there was no significant difference in CD44 expression between the two groups (median H score: 105 [IQR: 63.8–155.0] vs 60 [IQR: 30–120], P = 0.095). The ROC analysis of CD133 immunostaining yielded an area under the curve (AUC) of 0.881 (95% CI: 0.756–1.000) for differentiating between BCC and TB by using a H score of 7 as the cut-off value (98.5% sensitivity and 87.0% specificity). By contrast, immunostaining of CD44 showed a lower diagnostic value, with an AUC of 0.642 (95% CI: 0.476–0.808) at the optimal cut-off value of 85 (62.5% sensitivity and 73.9% specificity). The positive and negative predictive values were 88.5% and 95.2% for CD133 and 71.4% and 65.4% for CD44, respectively. Additionally, CD133 expression was significantly associated with mitotic activity in BCC patients (r = 0.549, P = 0.005). Conclusion Our study expanded upon previous studies of CD133 and CD44 expressions in skin tumors, suggesting that CD133, but not CD44, may serve as a novel biomarker for differential diagnosis of BCC, although future studies using a larger number of patients are needed to justify it further.
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Affiliation(s)
- Yalan Bi
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
| | - Xiaohua Shi
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Dian Chen
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
| | - Yi Zhao
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
- Correspondence: Yi Zhao, Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, People’s Republic of China, Tel/Fax +86 010 56119127, Email
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4
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Yu S, Wang Y, Tang B, Liu X, Song L, Xu G, Zhu H, Sun H. Four calcium signaling pathway-related genes were upregulated in microcystic adnexal carcinoma: transcriptome analysis and immunohistochemical validation. World J Surg Oncol 2022; 20:142. [PMID: 35509066 PMCID: PMC9066904 DOI: 10.1186/s12957-022-02601-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/15/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Microcystic adnexal carcinoma (MAC) is a skin cancer with challenges in diagnosis and management. This study was aimed to detect molecular alterations of MAC and guide its pathologic diagnosis and treatment. METHODS We performed transcriptome analysis on 5 MAC and 5 normal skin tissues, identified the differentially expressed genes, and verified them by immunohistochemistry. RESULTS Three hundred four differentially expressed genes (DEGs) in MAC were identified by next-generation transcriptome sequencing, among which 225 genes were upregulated and 79 genes were downregulated. Four genes of the calcium signaling pathway, including calcium voltage-gated channel subunit alpha 1 S (CACNA1S), ATPase sarcoplasmic/endoplasmic reticulum Ca2+ transporting 1 (ATP2A1), ryanodine receptor 1 (RYR1), and myosin light chain kinase 3 (MYLK3), were upregulated and then been verified by immunohistochemistry. The expression of CACNA1S, ATP2A1, RYR1, and MYLK3 was upregulated in MAC compared with normal sweat glands and syringoma tumor cells and was generally negative in trichoepithelioma and infundibulocystic type basal cell carcinoma. CONCLUSIONS The four genes of the calcium signaling pathway were upregulated in MAC at both RNA and protein levels. CACNA1S, ATP2A1, RYR1, and MYLK3 may be new diagnostic molecular markers and therapeutic targets for MAC.
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Affiliation(s)
- Shuaixia Yu
- Department of Pathology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32, West Second Section, First Ring Road, Chengdu, 610072, China.,Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yang Wang
- Department of Pathology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Baijie Tang
- Department of Pathology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32, West Second Section, First Ring Road, Chengdu, 610072, China.,Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Xiang Liu
- Department of Pathology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32, West Second Section, First Ring Road, Chengdu, 610072, China.,Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Linhong Song
- Department of Pathology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32, West Second Section, First Ring Road, Chengdu, 610072, China.,Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Gang Xu
- Department of Pathology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32, West Second Section, First Ring Road, Chengdu, 610072, China.,Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Hong Zhu
- Department of Pathology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32, West Second Section, First Ring Road, Chengdu, 610072, China. .,Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| | - Huajun Sun
- Department of Pathology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32, West Second Section, First Ring Road, Chengdu, 610072, China. .,Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China.
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匡 天, 刘 得. [Fibroproliferative trichoepithelioma grows behind the ear: a case report]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:389-390. [PMID: 35483693 PMCID: PMC10128264 DOI: 10.13201/j.issn.2096-7993.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Indexed: 06/14/2023]
Abstract
Trichoepithelioma is a kind of rare benign tumor of the skin that occurs in direct sunlight and is usually small. Large solitary trichoepithelioma behind the ear is rare. The pathological result of this patient was fibroproliferative trichoepithelioma. This type of tumor is rare and has no specific tumor markers. Diagnosis can be decided based on its histological characteristics. Combined with the appearance and histological characteristics of other types of trichoepithelioma, it can be concluded that this tumor is a special type of connective tissue hyperplastic trichoepithelioma.
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Affiliation(s)
- 天杰 匡
- 大连市中心医院耳鼻咽喉头颈外科(辽宁大连,116033)Department of Otorhinolaryngology Head and Neck Surgery, Dalian Central Hospital, Dalian, 116033, China
| | - 得龙 刘
- 大连市中心医院耳鼻咽喉头颈外科(辽宁大连,116033)Department of Otorhinolaryngology Head and Neck Surgery, Dalian Central Hospital, Dalian, 116033, China
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Recent Advances on Immunohistochemistry and Molecular Biology for the Diagnosis of Adnexal Sweat Gland Tumors. Cancers (Basel) 2022; 14:cancers14030476. [PMID: 35158743 PMCID: PMC8833812 DOI: 10.3390/cancers14030476] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Cutaneous sweat gland tumors form an extremely diverse and heterogeneous group of neoplasms that show histological differentiation to the sweat apparatus. Due to their rarity, wide diagnostic range, and significant morphological overlap between entities, their accurate diagnosis remains challenging for pathologists. Until recently, little was known about the molecular pathogenesis of adnexal tumors. Recent findings have revealed a wide range of gene fusions and other oncogenic factors that can be used for diagnostic purposes and, for some, can be detected by immunohistochemistry. Among other organs containing exocrine glands, such as salivary glands, breasts, and bronchi, most of these biomarkers have been reported in homologous neoplasms that share morphological features with their cutaneous counterparts. This review aims to describe these recent molecular and immunohistochemical biomarkers in the field of sweat gland tumors. Abstract Cutaneous sweat gland tumors are a subset of adnexal neoplasms that derive or differentiate into the sweat apparatus. Their great diversity, rarity, and complex terminology make their pathological diagnosis challenging. Recent findings have revealed a wide spectrum of oncogenic drivers, several of which are of diagnostic interest for pathologists. Most of these molecular alterations are represented by gene fusions, which are shared with other homologous neoplasms occurring in organs containing exocrine glands, such as salivary and breast glands, which show similarities to the sweat apparatus. This review aims to provide a synthesis of the most recent immunohistochemical and molecular markers used for the diagnosis of sweat gland tumors and to highlight their relationship with similar tumors in other organs. It will cover adenoid cystic carcinoma (NFIB, MYB, and MYBL1 fusion), cutaneous mixed tumor (PLAG1 fusion), cylindroma and spiradenoma and their carcinomas thereof (NF-κB activation through CYLD inactivation or ALKP1 hotspot mutation), hidradenoma and hidradenocarcinoma (MAML2 fusion), myoepithelioma (EWSR1 and FUS fusion), poroma and porocarcinoma (YAP1, MAML2, and NUTM1 fusion), secretory carcinoma (ETV6, NTRK3 fusion), tubular adenoma and syringo-cystadenoma papilliferum (HRAS and BRAF activating mutations). Sweat gland tumors for which there are no known molecular abnormalities will also be briefly discussed, as well as potential future developments.
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Hotak MK, He M. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac042. [PMID: 35211288 PMCID: PMC8863396 DOI: 10.1093/jscr/rjac042] [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: 12/17/2021] [Accepted: 01/18/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Mirwais Khan Hotak
- Correspondence address. 3 Mary Potter Circuit Bruce 2617 Canberra ACT, Australia. E-mail: ; Tel: +61 62016111; Fax: +61 262016182
| | - Mike He
- Department of General Surgery, Calvary Public Hospital, Canberra 2601, Australia
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8
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Monteagudo C, Fúnez R, Sánchez-Sendra B, González-Muñoz JF, Nieto G, Alfaro-Cervelló C, Murgui A, Barr RJ. Cutaneous Lymphadenoma Is a Distinct Trichoblastoma-like Lymphoepithelial Tumor With Diffuse Androgen Receptor Immunoreactivity, Notch1 Ligand in Reed-Sternberg-like Cells, and Common EGFR Somatic Mutations. Am J Surg Pathol 2021; 45:1382-1390. [PMID: 34232601 PMCID: PMC8428866 DOI: 10.1097/pas.0000000000001727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The term "cutaneous lymphadenoma" was coined in this journal for an unusual lymphoepithelial cutaneous adnexal neoplasm, possibly with immature pilosebaceous differentiation. Some authors further proposed that cutaneous lymphadenoma was an adamantinoid trichoblastoma. However, although a hair follicle differentiation is widely accepted, the fact that this is a lymphoepithelial tumor is not appropriately explained by the trichoblastoma hypothesis. Our goal was to further clarify the phenotypic and genotypic features of cutaneous lymphadenoma in a series of 11 cases. Histologically, a lobular architecture surrounded by a dense fibrous stroma was present in all cases. The lobules were composed of epithelial cells admixtured with small lymphocytes and isolated or clustered large Reed-Sternberg-like (RS-L) cells. The epithelial cells were diffusely positive for the hair follicle stem cell markers CK15, PHLDA1, and for androgen receptor. No immunostaining for markers of sebaceous differentiation was found. Intraepithelial lymphocytes were predominantly CD3+, CD4+, FoxP3+ T cells. RS-L cells showed both strong Jagged-1 and Notch1 cytoplasmic immunostaining. Androgen-regulated NKX3.1 nuclear immunostaining was present in a subset of large intralobular cells in all cases. Double immunostaining showed coexpression of NKX3.1 and CD30 in a subset of RS-L cells. No immunostaining for lymphocytic or epithelial markers was present in RS-L cells. EGFR, PIK3CA, and FGFR3 somatic mutations were found by next-generation sequencing in 56% of the cases. We consider that cutaneous lymphadenoma is a distinct benign lymphoepithelial tumor with androgen receptor and hair follicle bulge stem cell marker expression, RS-L cell-derived Notch1 ligand, and common EGFR gene mutations.
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Affiliation(s)
- Carlos Monteagudo
- Department of Pathology, University Clinic Hospital, INCLIVA Biomedical Research Institute
- Departments of Pathology
| | - Rafael Fúnez
- Department of Pathology, Costa del Sol Health Agency, Málaga, Spain
| | | | - José F. González-Muñoz
- Department of Pathology, University Clinic Hospital, INCLIVA Biomedical Research Institute
| | | | - Clara Alfaro-Cervelló
- Department of Pathology, University Clinic Hospital, INCLIVA Biomedical Research Institute
| | - Amelia Murgui
- Biochemistry and Molecular Biology, University of Valencia, Valencia
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Microcystic adnexal carcinoma: report of rare cases. Biosci Rep 2020; 40:221808. [PMID: 31912868 PMCID: PMC6974419 DOI: 10.1042/bsr20191557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 12/20/2019] [Accepted: 01/06/2020] [Indexed: 01/21/2023] Open
Abstract
Microcystic adnexal carcinoma (MAC) is a rare, locally aggressive malignant neoplasm that derives from cutaneous eccrine/apocrine glands. MAC is classified as an eccrine/apocrine gland tumor and usually occurs in the skin. Here, we characterized and compared two cases of MAC. One is extremely rare in terms of its occurrence in the tongue. The other occurred in the lip, which is common. Histories of disease, diagnosis, and differentials were reviewed by the attending physicians. Hematoxylin and Eosin (HE) slides were evaluated by an experienced pathologist. Immunological markers for malignant eccrine/apocrine gland tumors were used to characterize the tumor’s nature. The examined markers included EMA, CK5/6, CK8/18, CK7, CK20, p63, S-100, Calponin, CD10, MYB, Bcl-2, Her-2, CD34, SMA, p53, CD43, CD117, and Ki-67. Both patients were males, presented with painless lumps in the lower lip and in the tongue, respectively. Both lumps were similar in terms of appearance, being whitish, and infiltrative with irregular borders. Both tumors also had similar histological features with nests of bland keratinocytes, cords, and ductal differentiation filled with Periodic acid–Schiff (PAS)-positive eosinophilic material. In both cases, circular or ovary tumor cells invaded into muscles and nerves. All tumor cells were CK5/6, CK8/18, EMA, and CK7 positive. Particularly, keratinocytes were p63 positive, and paraductal cells were p63, S-100, and SMA positive. Therefore, the rare case of MAC in the tongue appears to derive from the salivary gland.
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Rahman J, Tahir M, Arekemase H, Murtazaliev S, Sonawane S. Desmoplastic Trichoepithelioma: Histopathologic and Immunohistochemical Criteria for Differentiation of a Rare Benign Hair Follicle Tumor From Other Cutaneous Adnexal Tumors. Cureus 2020; 12:e9703. [PMID: 32923292 PMCID: PMC7486105 DOI: 10.7759/cureus.9703] [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] [Indexed: 11/05/2022] Open
Abstract
Desmoplastic trichoepitheliomas (DTEs) are benign cutaneous neoplasms that originate from the hair follicle and exhibit a preference for the facial region. This type of neoplasm is characterized by accelerated growth, with vigorous histologic and immunohistochemical features that may be confused with other skin cancers. Thus, the objective of this study is to establish a definitive diagnosis that can be widely used. This review was systematically carried out and includes case series and studies to establish valuable data that can be used for research. The articles were sought in PubMed, MEDLINE, and Google Scholar using the keywords "desmoplastic trichoepithelioma," "morphea basal cell carcinoma," "microcystic adnexal carcinoma," "syringoma," and "cutaneous breast carcinoma." From a total of 65 journal articles, we chose 42 studies describing the clinical features, etiology, histopathology, and immunohistochemical characteristics of tumors. After quality assessment, 10 studies were selected, representing the differentiating features among the four mentioned cutaneous tumors. The differential diagnosis of DTE also includes other cutaneous and follicular tumors. At present, there is no standardized grading system for trichogenic tumors, although several symptomatic terms have been offered. More recently, immunohistochemistry and histopathological studies support the differentiation between the above-mentioned cutaneous tumors. However, additional research needs to be conducted to obtain complete information regarding the specific distinct traits of the indicated cutaneous tumors.
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Affiliation(s)
- Jawaria Rahman
- Pathology, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Muhammad Tahir
- Pathology, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Hassan Arekemase
- Anatomical and Clinical Pathology, Saint Barnabas Medical Center, Livingston, USA
| | - Salikh Murtazaliev
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Dika E, Scarfì F, Ferracin M, Broseghini E, Marcelli E, Bortolani B, Campione E, Riefolo M, Ricci C, Lambertini M. Basal Cell Carcinoma: A Comprehensive Review. Int J Mol Sci 2020; 21:ijms21155572. [PMID: 32759706 PMCID: PMC7432343 DOI: 10.3390/ijms21155572] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/25/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common type of carcinoma worldwide. BCC development is the result of a complex interaction between environmental, phenotypic and genetic factors. However, despite the progress in the field, BCC biology and mechanisms of resistance against systemic treatments have been poorly investigated. The aim of the present review is to provide a revision of BCC histological and molecular features, including microRNA (miRNA) dysregulation, with a specific focus on the molecular basis of BCC systemic therapies. Papers from the last ten years regarding BCC genetic and phenotypic alterations, as well as the mechanism of resistance against hedgehog pathway inhibitors vismodegib and sonidegib were included. The involvement of miRNAs in BCC resistance to systemic therapies is emerging as a new field of knowledge.
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Affiliation(s)
- Emi Dika
- Division of Dermatology, Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, 40138 Bologna, Italia; (F.S.); (M.L.)
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-0512144849
| | - Federica Scarfì
- Division of Dermatology, Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, 40138 Bologna, Italia; (F.S.); (M.L.)
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy
| | - Manuela Ferracin
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.F.); (E.B.); (M.R.)
| | - Elisabetta Broseghini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.F.); (E.B.); (M.R.)
| | - Emanuela Marcelli
- Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (E.M.); (B.B.)
| | - Barbara Bortolani
- Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (E.M.); (B.B.)
| | - Elena Campione
- Dermatology Clinic, University of Rome Tor Vergata Rome, 00133 Rome, Italy;
| | - Mattia Riefolo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.F.); (E.B.); (M.R.)
| | | | - Martina Lambertini
- Division of Dermatology, Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, 40138 Bologna, Italia; (F.S.); (M.L.)
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy
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Abstract
Ber-EP4 has been the traditional immunostain used for the detection of basaloid skin tumors. Recently, MOC-31 has shown be superior to Ber-EP4 in the detection of basosquamous basal cell carcinoma (BCC) and many centers are now using both Ber-EP4 and MOC-31 antibodies together to detect these lesions. The objective of this study was to compare the utility of using both Ber-EP4 and MOC-31 immunostains in the detection of basaloid skin tumors and to better characterize the previously unknown staining properties of MOC-31 in cutaneous lesions. To do this, 76 basaloid skin tumors stained with both Ber-EP4 and MOC-31 were obtained. Diagnoses included basosquamous BCC, Merkel cell carcinoma, adenoid cystic carcinoma, microcystic adnexal carcinoma, sebaceous carcinoma, trichoepithelioma, trichoblastoma, sebaceous adenoma, sebaceoma, and follicular induction overlying dermatofibroma. The distribution and intensity of Ber-EP4 and MOC-31 staining in these lesions was scored. These scores were analyzed using a truth table, χ test, and Pearson correlation tests. The overall mean and SD of the scores were also obtained. Overall, we found Ber-EP4 and MOC-31 to be statistically equivalent immunostains for the diagnosis of basaloid skin tumors. We recommend the use of only one of these antibodies and favor MOC-31 for the detection of basaloid skin tumors. We also describe MOC-31 staining properties in different cutaneous lesions.
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Mir-Bonafé JF, Mir-Bonafé M, Mir-Bonafé JM, Rozas-Muñoz E, Piquero-Casals J, Terrasa-Sagristà F. Trichoadenoma: dermoscopic clues of a rare adnexal tumour. Australas J Dermatol 2020; 62:75-77. [PMID: 32671822 DOI: 10.1111/ajd.13394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Marc Mir-Bonafé
- Department of Dermatology, Hospital Universitario Central de Astúrias, Universidad de Oviedo, Oviedo, Spain
| | | | | | - Jaime Piquero-Casals
- Department of Dermatology, Clínica Dermatológica Multidisciplinar Dermik, Barcelona, Spain
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14
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Next-generation sequencing implicates oncogenic roles for p53 and JAK/STAT signaling in microcystic adnexal carcinomas. Mod Pathol 2020; 33:1092-1103. [PMID: 31857679 DOI: 10.1038/s41379-019-0424-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 12/21/2022]
Abstract
Microcystic adnexal carcinoma is a locally aggressive sweat gland carcinoma characterized by its infiltrative growth and histopathologic overlap with benign adnexal tumors, often posing challenges to both diagnosis and management. Understanding the molecular underpinnings of microcystic adnexal carcinoma may allow for more accurate diagnosis and identify potential targetable oncogenic drivers. We characterized 18 microcystic adnexal carcinomas by targeted, multiplexed PCR-based DNA next-generation sequencing of the coding sequence of over 400 cancer-relevant genes. The majority of cases had relatively few (<8) prioritized somatic mutations, and lacked an ultraviolet (UV) signature. The most recurrent mutation was TP53 inactivation in four (22%) tumors. Frame-preserving insertions affecting the kinase domain of JAK1 were detected in three (17%) cases, and were nonoverlapping with TP53 mutations. Seven (39%) cases demonstrated copy number gain of at least one oncogene. By immunohistochemistry, p53 expression was significantly higher in microcystic adnexal carcinomas with TP53 mutations compared with those without such mutations and syringomas. Similarly, phospho-STAT3 expression was significantly higher in microcystic adnexal carcinomas harboring JAK1 kinase insertions compared with those with wild-type JAK1 and syringomas. In conclusion, microcystic adnexal carcinomas are molecularly heterogeneous tumors, with inactivated p53 or activated JAK/STAT signaling in a subset. Unlike most other nonmelanoma skin cancers involving sun-exposed areas, most microcystic adnexal carcinomas lack evidence of UV damage, and hence likely originate from a relatively photo-protected progenitor population in the dermis. These findings have implications for the biology, diagnosis, and treatment of microcystic adnexal carcinomas, including potential for therapeutic targeting of p53 or the JAK/STAT pathway in advanced tumors.
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15
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Koga K, Anan T, Fukumoto T, Fujimoto M, Nabeshima K. Ln-γ 2 chain of laminin-332 is a useful marker in differentiating between benign and malignant sclerosing adnexal neoplasms. Histopathology 2020; 76:318-324. [PMID: 31429981 DOI: 10.1111/his.13974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 08/17/2019] [Indexed: 11/26/2022]
Abstract
AIMS Laminin (Ln)-γ 2, one of the chains of Ln-332, is a marker of invasive tumours and is frequently expressed as a monomer in malignant tumours. Desmoplastic trichoepithelioma (DTE), some types of basal cell carcinoma (BCC) (infiltrating and morphoeic BCC) and microcystic adnexal carcinoma (MAC) belong to a group of tumours known as sclerosing adnexal neoplasms (SAN) that are frequently difficult to differentiate and often require immunohistochemistry for diagnosis. The aim of this study was to assess the usefulness of Ln-γ 2 expression in the differential diagnosis of DTE, infiltrating/morphoeic BCC, MAC and syringoma. METHODS AND RESULTS In this study, we compared the expression of Ln-γ 2 in infiltrating/morphoeic BCC (n = 28), DTE (n = 26), MAC (n = 10) and syringoma (n = 20). Immunohistochemically, Ln-γ 2 positivity was noted in 96% (27 cases) of infiltrating/morphoeic BCC and 90% (nine cases) of MAC, while all DTE and syringoma cases were negative. Furthermore, Ln-γ 2 expression pattern in infiltrating/morphoeic BCC was different from that in MAC. Ln-γ 2 expression was found in the cytoplasm of tumour cells in infiltrating/morphoeic BCC tumour cells, while in MAC linear expression was noted both along tumour nests and in the cytoplasm. CONCLUSION Ln-γ 2 is a helpful adjunct in the differential diagnosis of SAN.
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Affiliation(s)
- Kaori Koga
- Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
| | - Takashi Anan
- Sapporo Dermatopathology Institute, Sapporo, Japan
| | | | - Masakazu Fujimoto
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
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16
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Mehrpouya M, Pourhashem Z, Yardehnavi N, Oladnabi M. Evaluation of cytokeratin 19 as a prognostic tumoral and metastatic marker with focus on improved detection methods. J Cell Physiol 2019; 234:21425-21435. [PMID: 31042009 DOI: 10.1002/jcp.28768] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/13/2019] [Accepted: 04/17/2019] [Indexed: 12/24/2022]
Abstract
In the last few years, there has been a growing interest in Cytokeratin 19 (CK19) studies in the cancer research field. CK19 belongs to the Type I CKs, serves as a useful research tool in prognosis, diagnosis, and management of the tumors. In this paper, we dissect the metastatic potential of CK19, its relation with cancer stem cells and retinal epithelial cells behavior, its application as a tumor marker and its role among 30 cancers such as thyroid, thoracic, lung, pancreatic, cervical, colorectal, and so forth. CK19 expressed in several cancer types because of its metastatic potential. This paper also presents modified detection methods of CK19 in disseminated tumor cells.
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Affiliation(s)
- Masoumeh Mehrpouya
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Najmeh Yardehnavi
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Morteza Oladnabi
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran.,Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran.,Gorgan Congenital Malformations Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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17
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Fulton EH, Kaley JR, Gardner JM. Skin Adnexal Tumors in Plain Language: A Practical Approach for the General Surgical Pathologist. Arch Pathol Lab Med 2019; 143:832-851. [PMID: 30638401 DOI: 10.5858/arpa.2018-0189-ra] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Skin adnexal tumors, those neoplasms deriving from hair follicles and sweat glands, are often a source of confusion amongst even experienced pathologists. Many well-described entities have overlapping features, tumors are often only partially sampled, and many cases do not fit neatly into well-established classification schemes. OBJECTIVES.— To simplify categorization of adnexal tumors for the general surgical pathologist and to shed light on many of the diagnostic dilemmas commonly encountered in daily practice. The following review breaks adnexal neoplasms into 3 groups: sebaceous, sweat gland-derived, and follicular. DATA SOURCES.— Pathology reference texts and primary literature regarding adnexal tumors. CONCLUSIONS.— Review of the clinical and histopathologic features of primary cutaneous adnexal tumors, and the diagnostic dilemmas they create, will assist the general surgical pathologist in diagnosing these often challenging lesions.
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Affiliation(s)
- Edward H Fulton
- From the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock
| | - Jennifer R Kaley
- From the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock
| | - Jerad M Gardner
- From the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock
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18
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Llamas-Velasco M, Pérez-Gónzalez YC, Bosch-Príncep R, Fernández-Figueras MT, Rütten A. Solid carcinoma is a variant of microcystic adnexal carcinoma: A 14-case series. J Cutan Pathol 2018; 45:897-904. [PMID: 30187501 DOI: 10.1111/cup.13351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Solid carcinoma is a poorly characterized malignant apocrine neoplasm as only 16 cases have been published. OBJECTIVE To characterize its clinical, histopathological, and immunohistochemical features. METHODS We compiled 14 cases of solid carcinoma and clinical information were updated. Hematoxylin and eosin slides were reviewed and we stained all the cases for CEA, EMA, SMA, PHLDA-1, BerP4, nestin, p53, p63, p75, CK5/6, CK7 and some with remaining material for CK14, 15, CK10, CK19, S100, CD117, and CAM5. RESULTS All the lesions were located on the scalp. Histopathologically, all the cases were characterized by solid aggregates of neoplastic epithelial cells without nuclear atypia or mitotic figures involving all the dermis. All the cases presented perineural infiltration and most of them had cornified cystic structures. CK5/6 and p63 were positive. CEA and EMA underlined the scarce ducts. Ki67 was lower than 1%. BerEP4 and PHLDA-1 were negative. CONCLUSION Solid carcinoma is a solid variant of MAC affecting the scalp more frequently than classic MAC, mostly in old males and showing variable-sized nests involving the entire dermis and composed by poroid, clear-cells, or a mixture of both. It is positive for p63 and CK5/6 and negative for BerEP4 and PHLDA-1. Staining features with CK19 and PHLDA1 differ from classic MAC.
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Affiliation(s)
- Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.,Fundación de Investigación Sanitaria (IIS-IP), Madrid, Spain
| | - Yosmar Carolina Pérez-Gónzalez
- Pathology Department, Fundación Jiménez Diaz, Madrid, Spain.,Head of the Pathology Department, Dermatopathologist, Centro Médico Voth, Madrid, Spain
| | | | | | - Arno Rütten
- Dermatologist and Dermatopathologist, Friedrichshafen Dermatopathologie, Friedrichshafen, Germany
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19
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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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20
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Mostafa NA, Assaf M, Elhakim S, Abdel-Halim MRE, El-Nabarawy E, Gharib K. Diagnostic accuracy of immunohistochemical markers in differentiation between basal cell carcinoma and trichoepithelioma in small biopsy specimens. J Cutan Pathol 2018; 45:807-816. [DOI: 10.1111/cup.13305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/06/2018] [Accepted: 06/13/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Naglaa A. Mostafa
- Pathology Department; Faculty of Medicine, Zagazig University; Zagazig Egypt
| | - Magda Assaf
- Pathology Department; Faculty of Medicine, Zagazig University; Zagazig Egypt
| | - Sami Elhakim
- Pathology Department; Faculty of Medicine, Al-Azhar University; Cairo Egypt
| | | | - Eman El-Nabarawy
- Dermatology Department; Faculty of Medicine, Cairo University; Giza Egypt
| | - Khaled Gharib
- Dermatology Department; Faculty of Medicine, Zagazig University; Zagazig Egypt
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21
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Aslam A. Microcystic Adnexal Carcinoma and a Summary of Other Rare Malignant Adnexal Tumours. Curr Treat Options Oncol 2018; 18:49. [PMID: 28681209 DOI: 10.1007/s11864-017-0491-z] [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] [Indexed: 12/24/2022]
Abstract
OPINION STATEMENT Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, infiltrative malignant tumour most commonly found on the head and neck. It often presents as a solitary skin-coloured or yellow papule, plaque or nodule. Ultraviolet radiation, immunosuppression and ionising radiation are possible risk factors. Clinical and histological differential diagnoses include morpheaform basal cell carcinoma and desmoplastic trichoepithelioma. The diagnosis is usually made by skin biopsy, and the characteristic features are small keratin-filled cysts with nests and cords which resemble ductal structures. Immunohistochemistry can assist in differentiating MAC from other tumours. The local aggressive nature of the tumour and its potential to infiltrate beyond the assessed clinical margins warrant complete excision with marginal control, and we recommend Mohs micrographic surgery. Wide local excision is widely performed but is associated with recurrence given its infiltrative nature and extensive subclinical extension. The role of radiotherapy in the management of MAC is unclear.
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Affiliation(s)
- Arif Aslam
- St Helens and Knowsley Teaching Hospitals NHS Trust, Marshalls Cross Road, St Helens, WA9 3DA, UK.
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22
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Jean-Jacques B, Michels JJ, Veyssiere A, Haidar D. [Microcystic adnexal carcinoma: A case report]. Ann Pathol 2018; 38:198-201. [PMID: 29622469 DOI: 10.1016/j.annpat.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 03/05/2018] [Indexed: 11/25/2022]
Abstract
We report a case of microcystic adnexal carcinoma in a 80-year-old woman. This is a rare malignant adnexal cutaneous tumor with glandular and follicular differentiation, rare, often asymptomatic, with late diagnosis and slow growth, locally aggressive and rarely metastatic. The distinction with other benign and malignant skin tumors is difficult.
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Affiliation(s)
- Bastien Jean-Jacques
- Service d'anatomie pathologique, CHU de Caen, avenue côte-de-nacre, 14033 Caen, France.
| | - Jean-Jacques Michels
- Service d'anatomie pathologique, CHU de Caen, avenue côte-de-nacre, 14033 Caen, France
| | - Alexis Veyssiere
- Service de chirurgie maxillo-faciale, CHU de Caen, avenue côte-de-nacre, 14033 Caen, France
| | - Dima Haidar
- Service de dermatologie, CHU de Caen, avenue côte-de-nacre, 14033 Caen, France
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23
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Kinnersley B, Houlston RS, Bondy ML. Genome-Wide Association Studies in Glioma. Cancer Epidemiol Biomarkers Prev 2018; 27:418-428. [PMID: 29382702 DOI: 10.1158/1055-9965.epi-17-1080] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/12/2018] [Accepted: 01/17/2018] [Indexed: 01/23/2023] Open
Abstract
Since the first reports in 2009, genome-wide association studies (GWAS) have been successful in identifying germline variants associated with glioma susceptibility. In this review, we describe a chronological history of glioma GWAS, culminating in the most recent study comprising 12,496 cases and 18,190 controls. We additionally summarize associations at the 27 glioma-risk SNPs that have been reported so far. Future efforts are likely to be principally focused on assessing association of germline-risk SNPs with particular molecular subgroups of glioma, as well as investigating the functional basis of the risk loci in tumor formation. These ongoing studies will be important to maximize the impact of research into glioma susceptibility, both in terms of insight into tumor etiology as well as opportunities for clinical translation. Cancer Epidemiol Biomarkers Prev; 27(4); 418-28. ©2018 AACRSee all articles in this CEBP Focus section, "Genome-Wide Association Studies in Cancer."
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Affiliation(s)
- Ben Kinnersley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Melissa L Bondy
- Department of Medicine, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas.
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24
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The Use of BEREP4 Immunohistochemistry Staining for Detection of Basal Cell Carcinoma. J Skin Cancer 2017; 2017:2692604. [PMID: 29464122 PMCID: PMC5804366 DOI: 10.1155/2017/2692604] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/03/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022] Open
Abstract
Basal Cell Carcinoma (BCC) is the most common type of malignant cancer found in the world today with a 3–10% increase in incidence each year. The American Cancer Society reported that 8 out of 10 patients with skin cancer are suffering from BCC with over 2 million new cases each year. BCC needs to be detected at the early stages to prevent local destruction causing disabilities to patients and increasing treatment costs. Furthermore, BCC patients who have undergone surgery are still at risk for recurrence, especially when the surgery performed fails to remove all the BCC cells, even when conventional histopathological testing after surgery has reported a surgically free margin. This review aims to evaluate studies on the use of BerEP4 immunohistochemistry staining on pathological sections of various types of BCC as well as its shortfalls. BerEP4 is a monoclonal antibody which detects specific epithelial-glycoprotein-adhesion-molecules (EpCAM) found on BCC cells. Various studies have shown that BerEP4 has a high sensitivity and specificity in detecting only BCC cells. The use of BerEP4 immunohistochemistry testing for the routine examination of cases of BCC is expected to be able to increase and improve early diagnosis as well as prevent recurrence after surgery.
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25
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Abstract
CONTEXT - Basal cell carcinoma (BCC) is the most common human malignant neoplasm and is a frequently encountered diagnosis in dermatopathology. Although BCC may be locally destructive, it rarely metastasizes. Many diagnostic entities display morphologic and immunophenotypic overlap with BCC, including nonneoplastic processes, such as follicular induction over dermatofibroma; benign follicular tumors, such as trichoblastoma, trichoepithelioma, or basaloid follicular hamartoma; and malignant tumors, such as sebaceous carcinoma or Merkel cell carcinoma. Thus, misdiagnosis has significant potential to result in overtreatment or undertreatment. OBJECTIVE - To review key features distinguishing BCC from histologic mimics, including current evidence regarding immunohistochemical markers useful for that distinction. DATA SOURCES - Review of pertinent literature on BCC immunohistochemistry and differential diagnosis. CONCLUSIONS - In most cases, BCC can be reliably diagnosed by histopathologic features. Immunohistochemistry may provide useful ancillary data in certain cases. Awareness of potential mimics is critical to avoid misdiagnosis and resulting inappropriate management.
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Affiliation(s)
- Lauren M Stanoszek
- From the Departments of Pathology (Drs Stanoszek, Wang, and Harms) and Dermatology (Dr Harms), University of Michigan Medical School, Ann Arbor. Drs Stanoszek and Wang contributed equally
| | - Grace Y Wang
- From the Departments of Pathology (Drs Stanoszek, Wang, and Harms) and Dermatology (Dr Harms), University of Michigan Medical School, Ann Arbor. Drs Stanoszek and Wang contributed equally
| | - Paul W Harms
- From the Departments of Pathology (Drs Stanoszek, Wang, and Harms) and Dermatology (Dr Harms), University of Michigan Medical School, Ann Arbor. Drs Stanoszek and Wang contributed equally
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26
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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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27
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Agustí Martínez J, Bella-Navarro R, García-García AB, Bueno E, González-Sarmiento R, Navarro L, Sanchez-Sendra B, Revert A, Jordá E, Monteagudo C. Familial seborrhoeic keratosis associated with multiple 'pure reticulated acanthomas' and infundibulocystic basal cell carcinomas. Br J Dermatol 2017. [PMID: 28627087 DOI: 10.1111/bjd.15736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND A variety of genodermatoses with multiple cutaneous tumours and germline genetic alterations, such as PTCH1 mutations, have been described. Other cutaneous syndromes have been associated with somatic gene mutations, such as FGFR3 in familial seborrhoeic keratosis. OBJECTIVES To describe the clinical, dermoscopic and histopathological features of multiple cutaneous lesions, mostly infundibulocystic basal cell carcinomas (ICBCCs) and pure reticulated acanthomas, present in a family affected by familial seborrhoeic keratosis. In addition, we tested for possible germline alterations in FGFR3 and PTCH1. METHODS Ten members of one family were clinically examined and 92 skin biopsy specimens were evaluated. Blood samples from six individuals were analysed for FGFR3 and PTCH1 germline alterations. We reviewed the literature concerning genetic FGFR3 alterations in seborrhoeic keratosis. RESULTS Individuals of all generations affected by familial seborrhoeic keratosis also presented other skin tumours that corresponded histologically to reticulated acanthomas without apocrine or sebaceous differentiation, as well as ICBCCs. In addition, two novel germline variants, p.Pro449Ser (c.1345C>T) in FGFR3 and p.Pro725Ser (c.2173C>T) in exon 14 of PTCH1 were identified in five participants. CONCLUSIONS We characterize for the first time the clinical, dermoscopic and histopathological features of multiple reticulated acanthomas without apocrine or sebaceous differentiation, for which we propose the term 'pure reticulated acanthoma', and ICBCCs associated with familial seborrhoeic keratosis. We identified FGFR3 and PTCH1 germline polymorphisms whose influence in the development of reticulated acanthomas is unknown.
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Affiliation(s)
- J Agustí Martínez
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain.,Department of Pathology, Consorcio Hospitalario Provincial of Castellón, Valencia, Spain
| | - R Bella-Navarro
- Department of Dermatology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - A B García-García
- Genetic Diagnosis Unit, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - E Bueno
- Department of Molecular Medicine, University of Salamanca, Salamanca, Spain
| | | | - L Navarro
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - B Sanchez-Sendra
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - A Revert
- Department of Dermatology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - E Jordá
- Department of Dermatology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - C Monteagudo
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
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28
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Abstract
BACKGROUND Collagen is the most abundant protein in the body and the main structural component of the skin. OBJECTIVE To provide a review of the histopathology of collagen alterations and to propose a classification with the most important types of collagen anomalies in dermatopathology. The authors describe some of the main morphological clues of collagen anomalies for specific diagnosis of some cutaneous inflammatory and neoplastic conditions. METHODS The authors review histopathologic collagen anomalies, concerning both morphology and disposition in some inflammatory and neoplastic cutaneous conditions, and they review previous terminology and proposed a classification of the most important types of collagen anomalies that can be seen in dermatopathological practice. RESULTS Collagen anomalies in skin can be classified into lamellar fibrosis, sclerosis, and "balls" and "rings" of collagen. Lamellar fibrosis presents as long and thin collagen bundles forming a delicate network, which can be disposed in a parallel pattern, onion-bulb-like pattern, and storiform pattern. Sclerosis is characterized by large, thick, and eosinophilic bundles of collagen, which may present as a homogenous-diffuse pattern or as individual thick bundles of collagen with few or abundant number of fibroblasts between them. Finally, the authors propose the terms "balls" and "rings" of collagen. The term "balls" of collagen stands for thick, homogenous, eosinophilic, globular collagen bundles, with no distinguishable individual composing fibers, which include the floating sign and the free-floating sign. The term "rings" of collagen is characterized by sclerotic collagen arranged in a homogenous rimming pattern around vessels without independent fibers in its composition. CONCLUSIONS Collagen anomalies may be important clues to establish specific clues for specific diagnoses in dermatopathology.
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29
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Morpheaform Basal Cell Carcinomas With Areas of Predominantly Single-Cell Pattern of Infiltration: Diagnostic Utility of p63 and Cytokeratin. Am J Dermatopathol 2017; 38:744-50. [PMID: 27043336 DOI: 10.1097/dad.0000000000000541] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Morpheaform basal cell carcinoma (BCC) is a variant of BCC characterized by narrow strands and nests of basaloid cells with dense sclerotic stroma. The histologic extent often exceeds the clinical impression, leading to high recurrence rates after standard excision. The authors encountered a case with single-cell invasion distant from the main tumor. To date a systematic review of single-cell infiltration in morpheaform BCC has yet to be performed. DESIGN Ten morpheaform BCCs, 10 nonmorpheaform aggressive BCCs, 5 desmoplastic trichoepitheliomas, and 2 microcystic adnexal carcinomas were identified by database search and confirmed on hematoxylin and eosin. Cases were evaluated by hematoxylin and eosin, immunohistochemical staining for p63, and (in a subset) broad-spectrum cytokeratin. Single-cell pattern was defined as individual cells, 2-cell clusters, or single-file invasion. RESULTS Three types of single-cell pattern were identified: intratumoral (single cells within the main tumor mass), peripheral, and distant. Single cells were typically a minor component relative to larger tumor nodules and strands. Eight of the 10 cases of morpheaform BCC demonstrated areas of single-cell pattern: 3 intratumoral, 3 peripheral, and 2 with distant spread (0.75 and 1.0 mm from the main tumor). Eight of the 10 aggressive BCC demonstrated a peripheral single-cell pattern. Rare intratumoral single cells were identified in 3/5 desmoplastic trichoepitheliomas and 1/2 microcystic adnexal carcinomas. CONCLUSION Single-cell pattern is frequently a component of morpheaform BCC. Tumor cells at a significant distance from the main component were unique to morpheaform BCC. Thus, when evaluating margins for morpheaform BCC, increased caution is recommended, and immunohistochemical stains for p63 or cytokeratins may be helpful.
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30
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Romero-Pérez D, García-Bustinduy M, Cribier B. Clinicopathologic study of 90 cases of trichofolliculoma. J Eur Acad Dermatol Venereol 2016; 31:e141-e142. [PMID: 27608202 DOI: 10.1111/jdv.13960] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- D Romero-Pérez
- Department of Dermatology, University General Hospital of Alicante, Alicante, Spain
| | - M García-Bustinduy
- Department of Dermatology, University Hospital of Canarias, Canarias, Spain
| | - B Cribier
- Dermatopathology and Dermatology, Faculty of Medicine, University and University Hospital of Strasbourg, Strasbourg, France
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31
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Quist SR, Eckardt M, Kriesche A, Gollnick HP. Expression of epidermal stem cell markers in skin and adnexal malignancies. Br J Dermatol 2016; 175:520-30. [PMID: 26914519 DOI: 10.1111/bjd.14494] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Epidermal stem cells are multipotent cells that maintain the skin epidermis. Potential markers for stem cells have been identified in mammalian skin from mouse experiments; however, it is unclear if stem cells also contribute to tumour formation in human skin. OBJECTIVES To investigate the expression of potential stem cell markers, such as leucine-rich repeat-containing G protein-coupled receptor (Lgr) 5, Lgr6, leucine-rich repeats and immunoglobulin-like domain protein 1 (Lrig1) and cytokeratin 15 (CK15) in basal cell carcinomas and tumours of the skin appendages. METHODS We tested 45 human basal cell carcinomas (BCCs), including superficial, nodular, adenoid, infiltrating and sclerosing types, and 38 human tumours of skin appendages, including 13 sebaceous adenomas and carcinomas, 20 eccrine sweat gland tumours and five pilomatricomas, for the expression of hair follicle stem cell markers such as Lgr5, Lrig1, CK15, β-catenin and SRY (sex determining region Y)-box 9 (SOX9), and compared these findings with those of healthy age-matched human epidermis. RESULTS We detected the expression of stem cell markers in all tumours tested. Regarding Lgr5, Lrig1, CK15 and SOX9, expression seemed to be lower in more aggressive tumour types, such as in the most advanced parts of infiltrating BCC, in sebaceous carcinoma and late-stage porocarcinoma, compared with less aggressive superficial or nodular BCC or early-stage porocarcinoma and sebaceous gland tumours. In aggressive, sclerosing BCC, Lrig1 and Lgr5 were downregulated but CK15, SOX9 and nuclear β-catenin were upregulated. CONCLUSIONS Expression of potential stem cell markers of the epidermis and hair follicles was observed in skin tumours of appendages and BCCs. However, during tumour progression, many of these markers seemed to be downregulated.
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Affiliation(s)
- S R Quist
- Department of Dermatology and Venereology, Otto-von-Guericke University, Leipziger Strasse, Magdeburg, 39120, Germany.
| | - M Eckardt
- Department of Dermatology and Venereology, Otto-von-Guericke University, Leipziger Strasse, Magdeburg, 39120, Germany
| | - A Kriesche
- Department of Dermatology and Venereology, Otto-von-Guericke University, Leipziger Strasse, Magdeburg, 39120, Germany
| | - H P Gollnick
- Department of Dermatology and Venereology, Otto-von-Guericke University, Leipziger Strasse, Magdeburg, 39120, Germany
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32
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Moon SH, Choi HS, Kwon HI, Ko JY, Kim JE. A Case of Multiple Desmoplastic Trichoepithelioma. Ann Dermatol 2016; 28:411-3. [PMID: 27274652 PMCID: PMC4884730 DOI: 10.5021/ad.2016.28.3.411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/19/2015] [Accepted: 07/14/2015] [Indexed: 11/09/2022] Open
Affiliation(s)
- Seong Hun Moon
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Seok Choi
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Hyoung Il Kwon
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Eun Kim
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
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33
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Kinnersley B, Labussière M, Holroyd A, Di Stefano AL, Broderick P, Vijayakrishnan J, Mokhtari K, Delattre JY, Gousias K, Schramm J, Schoemaker MJ, Fleming SJ, Herms S, Heilmann S, Schreiber S, Wichmann HE, Nöthen MM, Swerdlow A, Lathrop M, Simon M, Bondy M, Sanson M, Houlston RS. Genome-wide association study identifies multiple susceptibility loci for glioma. Nat Commun 2015; 6:8559. [PMID: 26424050 PMCID: PMC4600760 DOI: 10.1038/ncomms9559] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/04/2015] [Indexed: 12/25/2022] Open
Abstract
Previous genome-wide association studies (GWASs) have shown that common genetic variation contributes to the heritable risk of glioma. To identify new glioma susceptibility loci, we conducted a meta-analysis of four GWAS (totalling 4,147 cases and 7,435 controls), with imputation using 1000 Genomes and UK10K Project data as reference. After genotyping an additional 1,490 cases and 1,723 controls we identify new risk loci for glioblastoma (GBM) at 12q23.33 (rs3851634, near POLR3B, P=3.02 × 10(-9)) and non-GBM at 10q25.2 (rs11196067, near VTI1A, P=4.32 × 10(-8)), 11q23.2 (rs648044, near ZBTB16, P=6.26 × 10(-11)), 12q21.2 (rs12230172, P=7.53 × 10(-11)) and 15q24.2 (rs1801591, near ETFA, P=5.71 × 10(-9)). Our findings provide further insights into the genetic basis of the different glioma subtypes.
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Affiliation(s)
- Ben Kinnersley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
| | - Marianne Labussière
- Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, F-75013 Paris, France
| | - Amy Holroyd
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
| | - Anna-Luisa Di Stefano
- Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, F-75013 Paris, France
- Onconeurotek, F-75013 Paris, France
- AP-HP, GH Pitié-Salpêtrière, Service de Neurologie 2, F-75013 Paris, France
| | - Peter Broderick
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
| | - Jayaram Vijayakrishnan
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
| | - Karima Mokhtari
- Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, F-75013 Paris, France
- Onconeurotek, F-75013 Paris, France
- AP-HP, GH Pitié-Salpêtrière, Laboratoire de neuropathologie R Escourolle, F-75013 Paris, France
| | - Jean-Yves Delattre
- Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, F-75013 Paris, France
- Onconeurotek, F-75013 Paris, France
- AP-HP, GH Pitié-Salpêtrière, Service de Neurologie 2, F-75013 Paris, France
| | - Konstantinos Gousias
- Department of Neurosurgery, University of Bonn Medical Center, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
| | - Johannes Schramm
- Department of Neurosurgery, University of Bonn Medical Center, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
| | - Minouk J. Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
| | - Sarah J. Fleming
- Centre for Epidemiology and Biostatistics, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK
| | - Stefan Herms
- Department of Biomedicine, Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany
- Division of Medical Genetics, Department of Biomedicine, University of Basel, 4056 Basel, Switzerland
| | - Stefanie Heilmann
- Department of Biomedicine, Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany
| | - Stefan Schreiber
- 1st Medical Department, University Clinic Schleswig-Holstein, Campus Kiel, House 6, Arnold-Heller-Straße 3, Kiel 24105, Germany
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Heinz-Erich Wichmann
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Chair of Epidemiology, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Markus M. Nöthen
- Department of Biomedicine, Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany
| | - Anthony Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
| | - Mark Lathrop
- AP-HP, GH Pitié-Salpêtrière, Laboratoire de neuropathologie R Escourolle, F-75013 Paris, France
- Foundation Jean Dausset-CEPH, 27 Rue Juliette Dodu, 75010 Paris, France
- Génome Québec, Department of Human Genetics, McGill University, Montreal, Quebec, Canada H3A 0G1
| | - Matthias Simon
- Department of Neurosurgery, University of Bonn Medical Center, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
| | - Melissa Bondy
- Division of Hematology-Oncology, Department of Pediatrics, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Marc Sanson
- Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, F-75013 Paris, France
- Onconeurotek, F-75013 Paris, France
- AP-HP, GH Pitié-Salpêtrière, Service de Neurologie 2, F-75013 Paris, France
| | - Richard S. Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
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Lepesant P, Crinquette M, Alkeraye S, Mirabel X, Dziwniel V, Cribier B, Mortier L. Vismodegib induces significant clinical response in locally advanced trichoblastic carcinoma. Br J Dermatol 2015; 173:1059-62. [PMID: 25998864 DOI: 10.1111/bjd.13919] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 11/30/2022]
Abstract
Patients with advanced basal cell carcinoma due to local extension or metastatic disease were previously at a therapeutic impasse. Targeted inhibition of the sonic hedgehog pathway by vismodegib represents a new therapeutic strategy. Adnexal carcinomas are rare malignant skin tumours derived from epithelial annexes. Conventional treatment of adnexal tumours is based on surgical excision. Although the radiosensitivity of adnexal carcinomas has not been established, radiotherapy could be offered alone or in combination in locally advanced or inoperable disease. Chemotherapy represents a therapeutic option in the treatment of metastatic adnexal tumours. Currently there is no effective treatment for these tumours when they become metastatic or unresectable, and treatment is palliative. Sunitinib represents a new therapeutic strategy, with efficiency described in the literature for a small number of patients. However, its efficacy is partial, and its tolerance is not always good. We report a patient with trichoblastic carcinoma, initially diagnosed as basal cell carcinoma, treated effectively with vismodegib. The remarkable response we have observed in this patient suggests an encouraging therapeutic role of vismodegib in trichoblastic carcinoma that should be evaluated in a carefully designed trial.
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Affiliation(s)
- P Lepesant
- Department of Dermatology, CHRU, Lille, France
| | | | - S Alkeraye
- Department of Dermatology, CHRU, Lille, France
| | - X Mirabel
- Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center, Lille, France
| | - V Dziwniel
- Department of Modern Languages, Ecole Centrale de Lille, Lille, France
| | - B Cribier
- Department of Pathology, CHRU, Strasbourg, France
| | - L Mortier
- Department of Dermatology, CHRU, Lille, France
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35
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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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36
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Evangelista MTP, North JP. Comparative analysis of cytokeratin 15, TDAG51, cytokeratin 20 and androgen receptor in sclerosing adnexal neoplasms and variants of basal cell carcinoma. J Cutan Pathol 2015; 42:824-31. [DOI: 10.1111/cup.12546] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 04/09/2015] [Accepted: 05/17/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jeffrey P. North
- Departments of Dermatology and Pathology; University of California; San Francisco CA USA
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37
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Frouin E, Vignon-Pennamen MD, Balme B, Cavelier-Balloy B, Zimmermann U, Ortonne N, Carlotti A, Pinquier L, André J, Cribier B. Anatomoclinical study of 30 cases of sclerosing sweat duct carcinomas (microcystic adnexal carcinoma, syringomatous carcinoma and squamoid eccrine ductal carcinoma). J Eur Acad Dermatol Venereol 2015; 29:1978-94. [PMID: 25873411 DOI: 10.1111/jdv.13127] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 03/02/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Microcystic adnexal carcinoma (MAC), syringomatous carcinoma (SC) and "Squamoid eccrine ductal carcinoma" (SEDC) are rare sclerosing adnexal tumours. OBJECTIVE To understand the histogenesis of these tumours and possible clinical implications. METHODS We conducted a retrospective study of 30 cases, 18 MAC, 5 SC and 7 SEDC reviewed and classified by a panel of dermatopathology experts, with immunohistochemical analysis of keratins, including K77, a new keratin specific of eccrine ducts, and PHLDA1 expressed in adnexal structures. RESULTS There was a strong female predominance, with only five cases occurring in men. Patients with MAC and SC were younger (mean age 56 and 47 years) than those with SEDC (mean age 81 years). The most common localization was the cheek in SC and SEDC and the periocular area in MAC. Two cases of SEDC were found in organ transplant patients. No recurrence or metastases were observed after complete surgery of MAC, or SC (mean follow-up 7.2 years and 4.7 years), whereas one case of SEDC recurred and another could not be fully excised. MAC and SC had similar histological features, except for cysts. In MAC, calcifications, granulomas, connection to follicles, keratin expression pattern, PHLDA1 positivity and K77 negativity indicated a follicular histogenesis, whereas in SC, K77 positivity and keratin expression pattern were consistent with a differentiation towards eccrine apparatus. SEDC was composed of strands centred by ducts and nests with squamous differentiation and displayed K77 ductal positivity in all cases, a finding consistent with an eccrine origin. CONCLUSION Our study demonstrated that MAC and SC have similar clinical characteristics, although histogenesis differs and show arguments for the individualization of SEDC.
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Affiliation(s)
- E Frouin
- Laboratoire d'Anatomie et de Cytologie Pathologiques, Hôpital Jean Bernard, CHU, Poitiers, France
| | - M D Vignon-Pennamen
- Service d'Anatomie pathologique, Hôpital Saint Louis, APHP, Paris, France.,Centre de Pathologie cutanée de la Roquette, 56 rue de la Roquette, Paris, France
| | - B Balme
- Laboratoire d'Anatomie pathologique, Centre hospitalier Lyon Sud, Lyon, France
| | - B Cavelier-Balloy
- Service d'Anatomie pathologique, Hôpital Saint Louis, APHP, Paris, France.,Cabinet d'Anatomie pathologique dermatologique, 35 avenue Mathurin Moreau, Paris, France
| | - U Zimmermann
- Centre de Pathologie cutanée de la Roquette, 56 rue de la Roquette, Paris, France.,Laboratoire d'Anatomie pathologique, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France
| | - N Ortonne
- Département de Pathologie, Hôpital Henri Mondor, APHP, Créteil, France
| | - A Carlotti
- Service d'Anatomie et de cytologie pathologiques, Hôpital Cochin-Tarnier, APHP, Paris, France
| | - L Pinquier
- Service d'Anatomie pathologique, Hôpital Saint Louis, APHP, Paris, France.,Laboratoire d'Anatomie pathologique, Centre hospitalier Lyon Sud, Lyon, France
| | - J André
- Centre d'Anatomie pathologique et de cytologie, Avenue du Diamant, Bruxelles, Belgium
| | - B Cribier
- Laboratoire d'Histopathologie cutanée, Clinique Dermatologique, Hôpital Civil, Strasbourg, France
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38
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Compton LA, Murphy GF, Lian CG. Diagnostic Immunohistochemistry in Cutaneous Neoplasia: An Update. Dermatopathology (Basel) 2015; 2:15-42. [PMID: 27047932 PMCID: PMC4816435 DOI: 10.1159/000377698] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Immunohistochemistry (IHC) is an important adjunct in the diagnosis of neoplastic skin diseases. In addition to the many established IHC markers currently in use, new markers continue to emerge, although their general acceptance and routine application requires robust validation. Here, we summarize the most well-established and commonly used biomarkers along with an array of newer ones reported in the past several decades that either demonstrate or hold high clinical promise in the field of cutaneous pathology. We also highlight recent applications of novel IHC markers in melanoma diagnosis including genetic mutation status markers [e.g. BRAF (v-raf murine sarcoma viral oncogene homolog B) and NRAS (neuroblastoma RAS viral oncogene homolog)] and an epigenetic alteration marker (e.g. 5-hydroxymethylcytosine). We specifically focus on the role of IHC in the differential diagnosis of cutaneous lesions that fall under the following categories: melanoma, epidermal tumors with an intraepidermal epitheliomatous pattern, spindle cell lesions of the dermis, small round blue cell tumors of the dermis, and cutaneous adnexal tumors. While IHC is a valuable tool in diagnostic dermatopathology, marker selection and interpretation must be highly informed by clinical context and the histologic differential diagnosis. With rapid progress in our understanding of the genetic and epigenetic mechanisms of tumorigenesis, new IHC markers will continue to emerge in the field of diagnostic dermatopathology.
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Affiliation(s)
- Leigh A Compton
- Program in Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA
| | - George F Murphy
- Program in Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA
| | - Christine G Lian
- Program in Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA
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39
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Benign subclinical syringomatous proliferations adjacent to a microcystic adnexal carcinoma: a tumor mimic with significant patient implications. Am J Dermatopathol 2014; 36:174-8. [PMID: 24061399 DOI: 10.1097/dad.0b013e3182a041a6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Microcystic adnexal carcinoma (MAC) is an uncommon, locally aggressive, malignant cutaneous tumor with pilar and eccrine differentiation. Mohs micrographic surgery is the treatment of choice for this condition, but specific histological findings can complicate MAC removal and leave doubt as to whether the tumor has been completely removed. Here we describe the clinical and pathological characteristics of a case in which a patient with an MAC underwent multiple reexcisions because of the presence of benign subclinical syringomatous proliferations adjacent to the primary lesion. Our case raises awareness of syringomatous proliferation, a benign process histologically similar but behaviorally distinct from a primary MAC. This experience highlights the importance of continued communication between dermatopathologists and dermatologic surgeons in providing quality patient care.
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40
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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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41
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Abstract
Adnexal tumors of the skin are epithelial skin tumors with differentiation towards the adnexal epithelial structures of the skin, namely, hair follicle, sebaceous gland, apocrine gland, and eccrine gland. Adnexal tumors include hamartomas, benign and malignant neoplasms, and hyperplasias. The specific diagnosis of adnexal tumors is important because some lesions such as sebaceous neoplasms, cylindromas, or fibrofolliculomas are herald lesions of hereditary tumor syndromes (e.g., Muir-Torre syndrome, familial cylindromatosis, Birt-Hogg-Dubé syndrome). In this article, the classification of adnexal tumors of the skin is explained on the basis of embryology and histology and the main features of tumor-associated syndromes are summarized. Moreover, some conceptual controversies and problems in differential diagnosis of cutaneous adnexal tumors are discussed.
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Affiliation(s)
- A Böer-Auer
- Dermatologikum Hamburg, Stephansplatz 5, 20354, Hamburg, Deutschland,
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