Figure 3 - uploaded by Rehan Zahid
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Prominent benign apocrine glands (left side) are noted close to the tumor (which is seen on the right lower side of the picture).
Source publication
Key Clinical Message
Primary apocrine sweat gland carcinoma is a rare neoplasm. It is usually slow growing and is often suspected to be a benign disease at initial assessment. A thorough clinical and histological workup is required for diagnosis. Treatment of choice is wide local excision with clear margins.
Context in source publication
Context 1
... to the pathology report, the differential diag- nosis included metastatic carcinoma to the axilla. Based on the finding of a large single mass with prominent apocrine glands in its vicinity and no accessory breast tis- sue, primary apocrine sweat gland carcinoma of the axilla was favored as a diagnosis (Fig. 3). Due to the rarity of this tumor, histopathology blocks were sent to the Pathol- ogy Department of Mayo Clinic, Rochester, USA for another opinion, which labeled the specimen as a low-grade papillary adenocarcinoma compatible with an ectopic breast primary or possibly a cutaneous adnexal carcinoma. Her2 IHC stain was performed with ...
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Citations
... Differential diagnosis of cutaneous primary apocrine adenocarcinoma (CPAA) includes the following: mammary carcinoma, lymph node metastasis, extramammary Paget's disease ceruminal carcinoma [5]. ...
... They show periodic acid-Schiff (PAS) positive diastase resistant intracytoplasmic granules. Features favoring apocrine adenocarcinoma over metastatic carcinoma include a transition zone between normal apocrine glands and neoplastic glands along with intracytoplasmic granules [5]. Similar findings were seen in our case. ...
... Treatment of choice for CPAA is wide local excision with clear margins, with or without regional lymph node dissection depending on the node status. Postoperative radiotherapy and chemotherapy has shown little benefit on outcomes [5]. There are no set guidelines for the management because of rarity and lack of clinical trials. ...
... However, there is no consensus about the adjuvant part of the treatment. There are cases in the literature where radiotherapy and chemotherapy have been used in adjuvant therapy or followed up after surgery (2,3,7). Apocrine cancer is resistant to chemotherapy. ...
Introduction: Primary apocrine sweat gland adenocarcinoma is a very rare tumour. Apocrin carcinoma is a high incicence of local recurrence and lymph node metastasis. When the location of the tumor is axilla, it should be differentiated from occult breast cancer. Surgery is the first step in primary apocrine cancer treatment. However, there is no clear consensus about adjuvant part of treatment.
Methods: The case with axillary apocrin carcinoma was presentated diagnosis, differential diagnosis and treatment approach.
Result : Axillary localized apocrine carcinoma was differentiated from occult breast cancer by pathological findings. For this reason, the patient was operated only an axillary dissection operation. Operated patient with axillary apocrine carcinoma was treated with radiotherapy. As a result of pathological evaluation of the tumor, tamoxifen was added to the treatment when the hormone receptor was positive.
Conclusions: The patient with apocrine carcinoma was treated with sequential radiotherapy and tamoxifen, and disease-free follow-up to this day
... However, there is no consensus about the adjuvant part of the treatment. There are cases in the literature where radiotherapy and chemotherapy have been used in adjuvant therapy or followed up after surgery [2,3,7]. Apocrine cancer is resistant to chemotherapy. ...
Background: Primary apocrine sweat gland adenocarcinoma is a very rare tumor. Apocrine carcinoma is a high incidence of local recurrence and lymph node metastasis. When the location of the tumor is axilla, it should be differentiated from occult breast cancer. Surgery is the first step in primary apocrine cancer treatment. However, there is no clear consensus about adjuvant part of treatment. In this case, we presented a 60-year old female patient with primary apocrine sweat gland carcinoma of the axilla. To our knowledge, this is the first case in the literature to use combined adjuvant radiation therapy and anti-estrogen therapy.
Case presentation: A 60-year old female patient presented with a slowly growing mass in the right axilla. The patient was examined by a surgeon and there was suspected to be metastasis from breast cancer diagnosed in September 2017. Axillary localized apocrine carcinoma was differentiated from occult breast cancer by pathological findings. For this reason, the patient was operated only an axillary dissection operation. Operated patient with axillary apocrine carcinoma was treated with radiotherapy. As a result of pathological evaluation of the tumor, tamoxifen was added to the treatment when the hormone receptor was positive.
Conclusions: The pathological features must be evaluated in detail for targeted treatment, which should be ap-plied with a multidisciplinary approach. Based on this case presentation and literature, adjuvant radiotherapy can be recommended to reduce the risk of local recurrence and hormone-therapy to reduce distant recurrence in patients with hormone-receptor positive primary apocrine carcinoma.
... Apocrine scent glands are characterized by the odour of their secretion, which is produced by the action of local bacteria. In humans, the majority of AACs develop in the axilla, followed by the anogenital region, which corresponds to the areas with greatest apocrine gland density (Higgins and Strutton, 1997;Cardoso and Calonje, 2015;Zahid et al., 2016;Angelico et al., 2017). The fact that the only case reported to date (Cameron and Conroy, 1976) and the present case both developed a scent adenocarcinoma in the chest area, is consistent with the high density of apocrine glands in this anatomical region in NHPs, particularly NWMs (Perkins and Ford, 1969;Matz-Rensing and Lowenstine, 2018). ...
In humans, apocrine gland tumours encompass a heterogeneous group of uncommon neoplasms with varied and unpredictable biological behaviour. They can be slow-growing lesions, recur after excision, produce lymph node metastasis in up to 50% of cases or lead to tumour-related death. We document a malignant scent adenocarcinoma in a wedge-capped capuchin monkey (Cebus olivaceus). Immunohistochemical labelling revealed complete absence of myoepithelial cells, a finding usually considered a hallmark of malignancy in humans; however, after a 2-year follow-up, the neoplasm had not recurred. This is the first detailed report of the pathology of a spontaneous scent (apocrine) gland adenocarcinoma in a non-human primate.
... In contrast, PASGC sometimes progresses aggressively, with the ability to metastasize [2]. When it arises at the axilla, differential diagnosis from breast carcinoma metastatic to the skin or apocrine carcinoma arising in ectopic breast tissue is essential [3,4]. Histological analysis and immunohistochemistry findings are helpful for effective diagnosis of the tumor. ...
Introduction
Primary apocrine sweat gland carcinoma (PASGC) is a rare subtype of sweat gland carcinoma, mostly occurring in the apocrine-dense regions such as the axilla, areola, and scalp.
Presentation of case
An 83-year-old woman developed a red elevating mass on her left axilla, without palpable axillary lymph nodes. Excision biopsy revealed that the tumor was PASGC. Additional wide resection and sentinel lymph node biopsy (SLNB) were performed without any adjuvant therapy. One year after the surgical procedure, the patient did not show any evidence of recurrence and axillary surgical complications.
Discussion
As PASGC arising in the axilla can progress aggressively, differential diagnosis is essential. Previous reports have shown the usefulness of SLNB, but the axillary management for patients with clinically node negative PASGC has not been established because of its rarity. Especially in axillary cases, to identify the true sentinel lymph nodes is sometimes considered inaccurate because the lymphatic flow is complicated in the axilla.
Conclusion
Although SLNB in sweat gland carcinoma has believed safety and been performed, this is the first axillary PASGC case that was performed SLNB. Careful follow-up is needed.
... Apocrine carcinoma (AC) of the sweat gland is an extremely rare neoplasm with around 50 cases reported in the literature so far [2,3]. It is usually a slow growing tumour, giving the clinical picture of a benign lesion but can sometimes progress aggressively to a malignant lesion. ...
... Mostly it affects the apocrine dense regions like axilla and anogenital region but it can also affect the scalp, eyelid, ear, lip, chest, nipple, fingers, and toes. Apocrine carcinoma frequently affects the elderly population with a median age of 67 but can occur at any age [2,3,5]. There is no racial or gender predisposition noted [4]. ...
... Paties., et al. proposed the following diagnostic criteria for AC: [2] Decapitation secretion, [2] PAS-positive diastase-resistant material in the cells or Lumina, and [3] Positive immunostaining for GCDFP-15 [11]. ...
... Numerous case studies and reports have been published by the HMC PET/CT center researches, disseminating their findings. Among them are diagnostic and treatment of numerous cancers including lung, sweat gland, Hodgkin lymphoma, granulosa cell tumor, and others as well as the palliative care [28][29][30]. However, 18 F is the only radioisotope available in Qatar as of today. ...
Background
A significant number of developing countries have no facilities producing medical radioisotopes.
Objective
In this paper we show that access to life-saving radioisotopes and radiopharmaceuticals and the geographical distribution of corresponding infrastructure is highly unbalanced worldwide.
Methods
We discuss the main issues which need to be addressed in order to establish the production of radioisotopes and radiopharmaceuticals, which are especially important for developing countries as newcomers in the field. The data was gathered from several sources, including databases maintained by the International Atomic Energy Agency (IAEA), World Health Organization (WHO), and other international organizations; personal interactions with representatives in the nuclear medicine field from different regions of the world; and relevant literature.
Results
Developing radioisotope and radiopharmaceutical production program and installing corresponding infrastructure requires significant investments, both man-power and financial. Support already exists to help developing countries establish their medical radioisotope production installations from several organizations, such as IAEA.
Conclusion
This work clearly shows that access to life-saving radioisotopes and the geographical distribution of corresponding infrastructure is highly unbalanced. Technology transfer is important as it not only immediate benefits patients, but also provide
... Typically, it is composed of large cells with eosinophilic cytoplasm, which commonly has Periodic acid-Schiff (PAS) positive, diastaseresistant material. 6 These cells also have hyperchromatic nuclei, mitotic figures and apocrine decapitation secretion. Immunohistochemistry may show positivity for GCDFP-15 and CD-15. ...
Primary apocrine carcinoma is a rare malignancy most commonly occurring in apocrine dense areas like axilla. There are only about 200 cases reported to date. We report a case of primary apocrine carcinoma present at an unusual site, that is, the arm. A wide local excision of the mass was done and was diagnosed as apocrine carcinoma on histopathological examination and was confirmed by immunohistochemistry. Wide local excision is the treatment required. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
... Primary apocrine sweat gland carcinoma is an extremely rare neoplasm with around 50 cases reported in the literature. The slow growing characteristic gives the clinical picture of benign tumor, but sometimes progress aggressively and with metastasis (1,2). The median age of the patient is around 67 years, without race or gender preference, related in axilla and anogenital area, but can be found in forehead, wrists, ear canals, eyelids, trunk, feet, toes, and fingers. ...
... The incidence of PASGC is quite low as 0.0049 to 0.0173 cases/100,000 people per year (1)(2)(3). Most of these lesions present indolent symptoms and slow growth rate that can delay diagnosis. ...
... The PASGC is a rare tumor with a simply treatment when there is no metastasis. The restricted literature about this disease is a barrier to define the best way to treat the patient (1)(2)(3)5). Maybe the most important predictor of survival is the lymph node status. ...
Introduction:
Primary apocrine sweat gland carcinoma (PASGC) is an extremely rare neoplasia whose management and treatment are still evolving. The only curative therapy is wide local excision. Many patients have metastasis at the time of the diagnosis, mainly because this neoplasm has been misdiagnosed as some benign skin lesions.
Presentation of case:
We herein report a case of a 72-year-old-man with PASGC affecting the axilla and regional lymph nodes that underwent surgical resection and lymphadenectomy at our Institution. This is the first case reported in Brazil.
Discussion:
Our observation suggests just a MRI as necessary to study tumoral limits and lymph nodes and a full surgical excision with free margins is decisive for success.
Conclusion:
Despite the PASGC be a rare cancer and require expensive tests, knowledge of this disease is critical to reduce costs in medical services without availability of investment.
