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Khoo P, Wen AY, Chai S. Primary cutaneous apocrine carcinoma of scrotum with pagetoid phenomenon. TURKISH JOURNAL OF PLASTIC SURGERY 2023. [DOI: 10.4103/tjps.tjps_46_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Kamanda S, Epstein JI, Osunkoya AO, Cimino-Mathews A, Argani P, Sangüeza M, Plaza JA, Matoso A. Poorly Differentiated Scrotal Carcinoma With Apocrine Immunophenotype. Am J Dermatopathol 2022; 44:260-266. [PMID: 34726185 PMCID: PMC8923942 DOI: 10.1097/dad.0000000000002100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Cutaneous carcinoma of the scrotum is rare with the most common type being squamous cell carcinoma. Here, we report 6 cases of poorly differentiated carcinoma with apocrine immunophenotype. Mean age at presentation was 68 years (range: 31-91 years). Clinical presentation included eczematous rash over mass, scrotal cyst, ulcerated mass, and mass. Tumor size ranged from 1.2 to 5.5 cm (average 2.5 cm). The tumors were solid with involvement of the dermis/hypodermis and composed of cords and nests of eosinophilic cells displaying nuclei with prominent nucleoli and surrounded by desmoplastic stroma. Focal squamous differentiation was evident in one case (17%). An intraductal component was seen in one case (17%). Pagetoid spread in the epidermis was seen in 3 cases. There was no morphologic evidence of apocrine differentiation. By immunohistochemistry, the tumor cells were positive for GCDFP-15 (n = 6/6), GATA3 (n = 6/6), CK7 (n = 5/5), AR (n = 4/4), and mammaglobin (n = 3/5). Five (83%) patients had metastases at diagnosis. Treatment included wide local excisions and inguinal lymph node dissection, followed by chemotherapy (gemcitabine, carboplatin; n = 3), trastuzumab/Lupron (n = 1), tamoxifen/Arimidex (n = 1), and radiotherapy (n = 1). Two patients (40%) were dead of disease, less than 2 years from diagnosis. Four patients developed metastases to lymph nodes, liver, bones, and lungs. Molecular analysis (n = 2) detected a HER-2 mutation in one and microsatellite instability in another. Although the presence of an intraepidermal pagetoid component could hint toward the diagnosis of invasive extramammary Paget disease, tumors without an intraepidermal component could be diagnostically challenging given the lack of morphologic evidence of apocrine differentiation.
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Affiliation(s)
- Sonia Kamanda
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
| | - Jonathan I. Epstein
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
- Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
| | - Adeboye O. Osunkoya
- Departments of Pathology and Urology, Emory University School of Medicine, Atlanta, GA, 30322
| | - Ashley Cimino-Mathews
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
| | - Pedram Argani
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
| | - Martin Sangüeza
- Department of Pathology, Hospital Obrero Nro.1 CNS, La Paz, Bolivia
| | | | - Andres Matoso
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
- Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231
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Collette F, Hamoir M, Van Eeckhout P, D’Abadie P, Duprez T, Schmitz S, Machiels J. Metastatic cutaneous apocrine adenocarcinoma successfully treated with systemic anti-androgen therapy-A case report. Clin Case Rep 2020; 8:3472-3478. [PMID: 33363954 PMCID: PMC7752452 DOI: 10.1002/ccr3.3434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/17/2020] [Accepted: 10/01/2020] [Indexed: 11/24/2022] Open
Abstract
Primary cutaneous apocrine adenocarcinoma (PCAC) is an extremely rare neoplasm involving the sweat glands. Due to a lack of cases, there is no consensus for the systemic treatment of locally advanced or metastatic PCAC. Anti-androgen therapy may have activity in inoperable or metastatic PCAC with high androgen receptor (AR) expression.
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Affiliation(s)
- Fanny Collette
- Institut Roi Albert IIDepartment of Medical OncologyCliniques universitaires Saint‐Luc and Institut de Recherche Clinique et Expérimentale (POLE MIRO)Université catholique de LouvainBrusselsBelgium
| | - Marc Hamoir
- Institut Roi Albert IIDepartment of Head and Neck SurgeryCliniques universitaires Saint‐Luc and Institut de Recherche Clinique et Expérimentale (POLE MIRO)Université catholique de LouvainBrusselsBelgium
| | - Pascal Van Eeckhout
- Institut Roi Albert IIDepartment of PathologyCliniques universitaires Saint‐LucBrusselsBelgium
| | - Philippe D’Abadie
- Institut Roi Albert IIDepartment of Nuclear MedicineCliniques universitaires Saint‐Luc and Institut de Recherche Clinique et Expérimentale (POLE MIRO)Université catholique de LouvainBrusselsBelgium
| | - Thierry Duprez
- Institut Roi Albert IIDepartment of Medical ImagingCliniques universitaires Saint‐LucBrusselsBelgium
| | - Sandra Schmitz
- Institut Roi Albert IIDepartment of Head and Neck SurgeryCliniques universitaires Saint‐Luc and Institut de Recherche Clinique et Expérimentale (POLE MIRO)Université catholique de LouvainBrusselsBelgium
| | - Jean‐Pascal Machiels
- Institut Roi Albert IIDepartment of Medical OncologyCliniques universitaires Saint‐Luc and Institut de Recherche Clinique et Expérimentale (POLE MIRO)Université catholique de LouvainBrusselsBelgium
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Affiliation(s)
- Justin Lee
- Department of Dermatology, West Virginia University, Morgantown, West Virginia
| | - William Farmer
- Department of Dermatology, West Virginia University, Morgantown, West Virginia
| | - Alan Thomay
- Department of Surgery, West Virginia University, Morgantown, West Virginia
| | - Katrin Kiavash
- Department of Pathology, West Virginia University, Morgantown, West Virginia
| | - Michael S Kolodney
- Department of Dermatology, West Virginia University, Morgantown, West Virginia
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Portelli F, Salvati L, Projetto E, Gori A, Scarfì F, Trane L, Lo Russo G, Innocenti A, De Giorgi V. A clinical, pathological and immunohistochemical series of 9 cases of primary cutaneous apocrine carcinomas of the head and neck. Australas J Dermatol 2019; 61:e189-e195. [PMID: 31736065 DOI: 10.1111/ajd.13199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 10/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES Primary cutaneous apocrine carcinoma is a rare malignant adnexal skin tumour that can recur locally, spread to regional lymph nodes and metastatize to visceral organs. Wide dissemination and death from disease are much less common. The axilla is the most common site of presentation. It is infrequently reported in the head and neck region. METHODS All cases diagnosed as primary cutaneous apocrine carcinoma of the head and neck were retrospectively collected from the archives of the Division of Pathological Anatomy, University of Florence from 1996 to 2016. There was no history or clinical evidence of breast cancer. Clinical data and follow-up were collected by the clinicians. RESULTS Nine cases were found, with a mean age of 76 years, ranging in size between 0.3 and 3.5 cm. Clinically, they were frequently mistaken for basal cell carcinomas. Histopathologically, all the tumours showed decapitation secretion, a tubular, solid or mixed (tubulo-papillary and solid-tubular) growth pattern and were predominantly classified as grade 2 tumours. GCDFP-15 and hormone receptors were variably expressed. HER2 and podoplanin were negative in all cases. In one case, spreading to regional lymph nodes was observed. No cases were associated with death due to the disease. CONCLUSION As immunohistochemical analysis lacks specificity in distinguishing primary cutaneous apocrine carcinoma from a cutaneous metastasis of breast carcinoma, detailed clinical history, breast examination, adequate treatment and follow-up are necessary to confirm a diagnosis of primary cutaneous apocrine carcinoma.
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Affiliation(s)
- Francesca Portelli
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Lorenzo Salvati
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Elisabetta Projetto
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Alessia Gori
- Cancer Research "Attilia Pofferi" Foundation, Pistoia, Italy
| | - Federica Scarfì
- Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Luciana Trane
- Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Giulia Lo Russo
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy
| | - Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy
| | - Vincenzo De Giorgi
- Cancer Research "Attilia Pofferi" Foundation, Pistoia, Italy.,Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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