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Microscopic findings show an intracystic papillary projection composed of some ill-defined tumor nests in the fibrotic wall, representing the in situ lesion of the tumor (black arrows, a, H&E, 10×). Note the invasive components (black arrowheads, a, H&E) adjacent to the in situ lesion (A 10×; inset, 100×). The tumor cells have abundant eosinophilic cytoplasm and vesicular nuclei with focal “apocrine-like” decapitation secretion (b, H&E, 400×), suggesting apocrine gland carcinoma
Source publication
Primary cutaneous apocrine gland carcinoma, which is a type of sweat gland carcinoma, is an extremely rare type of cancer. Clinical courses of this type of cancer usually progress slowly but can, occasionally, be associated with rapid progression. This case report describes a 53-year-old Korean man with primary cutaneous apocrine gland carcinoma th...
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Context 1
... there was no gross invasion into the sur- rounding tissue. Microscopic examination revealed an intracystic papillary projection (focal area with papillary projection), representing in situ carcinomatous lesions with apocrine features. A microscopic focus of the inva- sive carcinoma was identified in the cystic wall adjacent to the in situ lesions (Fig. 2a). Tumor cells had abun- dant eosinophilic cytoplasm and vesicular hyperchro- matic nuclei with focal decapitation secretion (Fig. 2b). Most tumor cells were located within the in situ lesions and in the papillary projections, and the tumor tissue focally invaded the cystic wall adjacent to the papillary projections. However, the tumor ...
Context 2
... area with papillary projection), representing in situ carcinomatous lesions with apocrine features. A microscopic focus of the inva- sive carcinoma was identified in the cystic wall adjacent to the in situ lesions (Fig. 2a). Tumor cells had abun- dant eosinophilic cytoplasm and vesicular hyperchro- matic nuclei with focal decapitation secretion (Fig. 2b). Most tumor cells were located within the in situ lesions and in the papillary projections, and the tumor tissue focally invaded the cystic wall adjacent to the papillary projections. However, the tumor had not invaded the surrounding tissue, such as subcutaneous tissue, muscle, or dermis (Fig. 2). Serial sections of the whole resected ...
Context 3
... matic nuclei with focal decapitation secretion (Fig. 2b). Most tumor cells were located within the in situ lesions and in the papillary projections, and the tumor tissue focally invaded the cystic wall adjacent to the papillary projections. However, the tumor had not invaded the surrounding tissue, such as subcutaneous tissue, muscle, or dermis (Fig. 2). Serial sections of the whole resected specimen failed to show breast parenchymal tissues. Im- munohistochemical study showed that the tumor cells were positive for cytokeratin AE1/AE3, gross cystic dis- ease fluid protein (GCDFP)-15 ( Fig. 3a, b), and estrogen and progesterone receptors ( Fig. 3c, d). Based on these findings, the ...
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Citations
... The standard treatment for PCAC is wide surgical resection and reconstruction (3,5,6). There is no clear consensus on management of regional lymph nodes, and the most important predictor of survival in localized disease is lymph node status; therefore, sentinel lymph node biopsy could be considered in management of this disease (4,5,6). ...
... The standard treatment for PCAC is wide surgical resection and reconstruction (3,5,6). There is no clear consensus on management of regional lymph nodes, and the most important predictor of survival in localized disease is lymph node status; therefore, sentinel lymph node biopsy could be considered in management of this disease (4,5,6). The role of adjuvant chemotherapy and radiotherapy is not established. ...
... We reviewed the literature to nd best surgical options and treatment modalities. PCAC of the scalp is a rare malignancy most often reported in the literature as case reports or small case-series, therefore there are no established protocols for PCAS treatment, especially for the giant form of PCAS (3,4,5). Most authors advised clear margins about 2 cm in width. ...
Background: Primary cutaneous apocrine carcinoma (PCAC), a subtype of sweat gland carcinoma, is an extremely rare malignant neoplasm. Distinguishing apocrine carcinoma from breast carcinoma metastasis is difficult even for pathologist. Most arise in regions of high apocrine gland density like axilla, and rarely on the scalp and eyelid, but it’s possible to occur elsewhere on the skin. Primary cutaneous apocrine carcinoma of the scalp is a rare malignancy most often reported in the literature as case reports or small case series. Giant form of primary cutaneous apocrine carcinoma in frontal region is not described in literature, to the best of our knowledge. There no established protocols for primary cutaneous apocrine carcinoma treatment.
Case presentation: We report a case giant primary cutaneous apocrine carcinoma localized in frontal region. Definitive diagnosis of primary cutaneous apocrine carcinoma is made by biopsy with microscopic and immunohistochemical analysis. Wide surgical excision and reconstruction with large local transposition flap and split thickness skin grafts for secondary defect were our therapy of choice.
Conclusion: Primary cutaneous apocrine carcinoma is very rare malignancy and giant form in not described yet. Surgical treatment provided the patients with the tumor free status as well satisfactory aesthetical appearances and quality of living.
Apocrine adenocarcinoma is a rare malignant neoplasm arising mostly in apocrine‐dense regions. Local recurrence and locoregional nodal metastasis are often observed, and most patients relapse at regional lymph nodes within 5 years. Here, we report a very rare case of cutaneous apocrine adenocarcinoma that metastasized to the lymph node more than 10 years after surgery.
