Primary cutaneous adenoid cystic carcinoma with brain metastases: case report and literature review

A Unique Case of Primary Cutaneous Adenoid Cystic Carcinoma Associated with Aplasia Cutis Congenita in a Four-Year-Old Female: A Case Report

Introduction: Primary cutaneous adenoid-cystic carcinoma (PCACC) is a rare malignant tumour reported in only about 450 cases in the literature, with only two adolescent cases reported. PCACC seems to occur between the fifth and seventh decade of life, and the most frequent regions involved are head and neck (46%). Aplasia cutis congenita (ACC) has an incidence of 1:10,000, and it seems to be rarely associated with neoplastic lesions. Interestingly, the association between PCACC and ACC has, so far, never been described. Methods: We report a case of PCACC in the scalp associated with ACC in a four-year-old patient. Discussion: The patient was under follow-up at the dermatology unit, but suddenly a red lesion appeared within the ACC. This red, ulcerated area increased rapidly over six months, so it was surgically removed, and the pathological examination results were suggestive for cribriform PCACC. According to the guidelines for skin tumours, the patient underwent widening resection, and an advancement-sliding skin flap was performed to recreate the scalp. After one year of follow-up, the patient has no local or widespread recurrence of the PCACC, and the surgical scar appears to have healed well. Conclusions: This clinical case is the first known patient with PCACC associated with ACC. A skin excision biopsy should be performed with wide margins to avoid a second widening resection of skin in a similar scenario. Genetic studies may help to identify the origin of this rare association.

Cutaneous Adenoid Cystic Carcinoma with Perineural Invasion Diagnosed in the Foot: A Case Report

Adenoid cystic carcinoma is a rare, slow-growing neoplasm. It is most commonly located in the salivary glands, affects people older than 55 years of age, and has a predilection for women. These lesions may recur locally but have shown low metastatic potential. We present the unique case of a 71-year-old female with a nonraised hyperpigmented lesion isolated to the right heel. Confusion surrounded the clinical presentation of this dermatologic lesion, and many physicians postulated several differential diagnoses. The purpose of this case report is to bring further awareness to this rare dermatologic variant of adenoid cystic carcinoma, which has been rarely reported in the literature.

Lung metastasis in primary cutaneous adenoid cystic carcinoma - Clinicopathological evaluation of a rare case with review of literature

Primary cutaneous adenoid cystic carcinoma (ACC) is an extremely rare and indolent cutaneous malignancy with very infrequent distant metastasis. We present a case of primary cutaneous ACC with bilateral lung metastases in a 57-year-old male along with literature review. To the best of our knowledge this is the tenth case of primary cutaneous ACC reported presenting with distant metastasis.

Primary cutaneous adenoid cystic carcinoma with MYB aberrations: report of three cases and comprehensive review of the literature

Adenoid cystic carcinoma (ACC) is a relatively rare slow-growing and often-aggressive epithelial-myoepithelial neoplasm that arises in multiple organs including the skin. The t(6;9) (q22-23;p23-24) translocation, resulting in a MYB-NFIB gene fusion has been found in ACCs from the salivary glands and other organs. Recently, MYB aberrations occurring in a subset (40%) of primary cutaneous ACC (PCACC) examples was described. Herein, we report three additional cases of PCACC harboring MYB aberrations. The tumors presented in three males aged 43, 81 and 55 years old and affected the extremities in the first two patients and the scalp in the third one. None of the patients had history of prior or concurrent ACC elsewhere. Lesions exhibited the classic ACC morphology of nests of basaloid cells arranged in cribriform and adenoid patterns. Sentinel lymph node biopsy was performed in two cases with one case showing lymph node positivity. Fluorescence in situ hybridization with break-apart probes for MYB and NFIB loci revealed that two cases showed MYB rearrangements while one case showed loss of one MYB signal. None of the cases showed NFIB rearrangements. We contribute with three additional cases of PCACC exhibiting MYB aberrations, the apparent driving genetic abnormality in these tumors.