1
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Tinguria M. Primary Mucinous Carcinoma of Skin: A Rare Cutaneous Neoplasm. Clinicopathologic Features, Differential Diagnoses, and Review of Literature. Am J Dermatopathol 2024; 46:114-120. [PMID: 38055969 DOI: 10.1097/dad.0000000000002591] [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: 12/08/2023]
Abstract
ABSTRACT Primary mucinous carcinoma of the skin (PMCS) is a rare malignant neoplasm of sweat gland origin, with an incidence of 0.07 per million. Histologically, it may be difficult to differentiate it from metastatic mucinous carcinomas of the skin. A case of PMCS is reported here in a 59-year-old woman who presented with a lesion on the right lower eyelid. Histological examination revealed features of mucinous adenocarcinoma. The main differential diagnosis was metastatic mucinous adenocarcinoma; however, the lack of colorectal and lung markers and the presence of focal in situ components were consistent with the diagnosis of PMCS. PMCS and breast mucinous carcinoma share immunohistochemical markers, such as GCDFP-15 and mammaglobin; however, focal in situ component with the presence of myoepithelial cells in the tumor ruled out metastatic mucinous carcinoma of breast origin. The subsequent mammograms did not reveal any breast lesions. Colonoscopy did not show any evidence of colonic malignancy, and imaging studies (CT scan) did not show any evidence of neoplasm in the body. These findings were in keeping with a diagnosis of PMCS. The present case emphasizes the importance of clinicopathological correlation, histopathology, and immunohistochemistry in the accurate diagnosis of PMCS and summarizes the literature on these rare cutaneous neoplasms.
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Affiliation(s)
- Mukund Tinguria
- Department of Pathology and Laboratory Medicine, Brantford General Hospital, Brantford, Ontario, Canada
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2
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Freeman T, Russell AJ, Council ML. Primary Cutaneous Mucinous Carcinoma: A Review of the Literature. Dermatol Surg 2023; 49:1091-1095. [PMID: 37643246 DOI: 10.1097/dss.0000000000003921] [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: 08/31/2023]
Abstract
BACKGROUND Primary cutaneous mucinous carcinoma (PCMC) is an exceedingly rare, low-grade tumor that histologically resembles mucinous carcinoma from other primary sites, such as the breast, gastrointestinal tract, and lungs. OBJECTIVE The purpose of this article was to review the current literature on PCMC as it relates to epidemiology, clinical presentation, histopathology, immunohistochemistry, treatment, and prognosis. MATERIALS AND METHODS An extensive literature review was conducted using PubMed and Ovid MEDLINE to identify articles related to PCMC. RESULTS Several hundred cases have been reported in the medical literature, and surgical resection, whenever feasible, is the standard of care. CONCLUSION The diagnosis of primary cutaneous mucinous carcinoma is one of exclusion, requiring a metastatic work-up to rule out distant primary. Mohs micrographic surgery is a tissue sparing technique that allows complete margin control of these rare neoplasia.
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Affiliation(s)
- Timothy Freeman
- Washington University School of Medicine, St. Louis, Missouri
| | - Aaron J Russell
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - M Laurin Council
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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3
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Choi YS, Jung DH, Chi M. Primary Mucinous Adenocarcinoma of the Lower Eyelid. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.3.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We report a case of a primary mucinous adenocarcinoma of the lower eyelid diagnosed in patient with a painless mass.Case summary: A 62-year-old male visited our clinic with a painless mass of the left lower eyelid of increasing the size for 2 months. Orbital computed tomography and magnetic resonance imaging revealed an approximately 2 cm well-defined ovoid, homogeneous enhancing mass in the left lower eyelid. A biopsy was performed under general anesthesia, and histopathologic examination confirmed mucinous adenocarcinoma. Final diagnosis was made as primary mucinous adenocarcinoma since torso positron emission tomography and computed tomography found no abnormal findings and extensive resection was performed for complete resection of the tumor.Conclusions: Primary mucinous adenocarcinoma that occurs in the eyelid is a very rare malignant tumor, and a systemic examination to determine whether it is metastatic is essential, and due to its high local recurrence, regular follow-up after extensive resection is required.
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4
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Casalou C, Tobin DJ. Modulating mucins makes melanin. Br J Dermatol 2021; 186:388-389. [PMID: 34817869 DOI: 10.1111/bjd.20877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- C Casalou
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, D04 V1W8, Dublin, Ireland
| | - D J Tobin
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, D04 V1W8, Dublin, Ireland.,The Conway Institute of Biomolecular and Biomedical Research, University College Dublin, D04 V1W8, Dublin, Ireland
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5
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Saleem R, Vaidya S. A Case of Eccrine Mucinous Carcinoma Involving Scalp. Cureus 2021; 13:e16469. [PMID: 34430089 PMCID: PMC8372668 DOI: 10.7759/cureus.16469] [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] [Accepted: 07/18/2021] [Indexed: 11/21/2022] Open
Abstract
The report presents a case of a 67-year-old female with a long-standing lump on the scalp. After its excision the histopathology revealed consistency with eccrine mucinous carcinoma. These neoplasms are quite rare with only around 100 cases reported since 1951. The report concludes the importance of encouraging follow-up of cutaneous lesions among patients as well as ongoing research to better identify and manage the tumor.
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Affiliation(s)
- Ramsha Saleem
- Dermatology, The Queen Elizabeth Hospital, Adelaide, AUS
| | - Sachin Vaidya
- Dermatology, The Queen Elizabeth Hospital, Adelaide, AUS
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Bagci B, Alhatem A, Fidan-Ozbilgin O. Granuloma Annulare - A Manifestation of Primary Cutaneous Mucinous Carcinoma? Cureus 2020; 12:e12304. [PMID: 33520503 PMCID: PMC7834588 DOI: 10.7759/cureus.12304] [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] [Accepted: 12/26/2020] [Indexed: 11/28/2022] Open
Abstract
The objective of this report is to present a rare case of primary cutaneous mucinous carcinoma (PCMC) manifesting with granuloma annulare (GA), and to discuss the association as a paraneoplastic phenomenon. A 65-year-old female presented with a painless, slow-growing, cystic nodule less than 1 cm over the left lateral canthus. The clinical presentation was highly suspicious of sebaceous cyst. The histopathologic examination revealed variable sizes of neoplastic cell clusters in a pool of abundant mucin. A focus of palisading lympho-histiocytic infiltrate surrounding a necrobiosis suggestive of granuloma annulare adjacent to the tumor is identified. Series of extensive investigations performed did not reveal any primary origin. GA can rarely be associated with various malignant conditions. Its association and prognostic importance to these conditions are unclear. The presence with certain malignancies and the resolution of GA with the treatment of underlying malignancy are an indicator that this condition can very well be a paraneoplastic phenomenon.
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Affiliation(s)
- Buket Bagci
- Pathology and Laboratory Medicine, St. Barnabas Hospital, Livingston, USA
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Primary mucinous carcinoma of the skin arising from the upper eyelid: A case report and literature review. JPRAS Open 2020; 25:18-23. [PMID: 32514425 PMCID: PMC7266996 DOI: 10.1016/j.jpra.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/08/2020] [Indexed: 11/23/2022] Open
Abstract
Primary mucinous carcinoma of the skin (PMCS) is a rare malignant neoplasm of the sweat glands that has an incidence of 1 per 150,000 population. Because of the lack of typical characteristics, it is often misdiagnosed as an epidermoid cyst, pilomatrixoma, or chalazion before resection, with subsequent enucleation performed unintentionally. We present a case of a 51-year-old patient with PMCS in the upper eyelid that was successfully treated at our hospital. Additionally, we reviewed the literature and discussed the diagnosis, primary and adjuvant therapy, and follow-up procedure.
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Abiola OO, Ano-Edward GH, Oluwumi OA, Lasisi ME. Primary cutaneous mucinous carcinoma of the scrotum: A rare tumor at a rare site - A case report and review of literature. Urol Ann 2019; 12:83-86. [PMID: 32015625 PMCID: PMC6978957 DOI: 10.4103/ua.ua_126_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/18/2019] [Indexed: 11/05/2022] Open
Abstract
Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant adnexal tumor of eccrine origin with a higher incidence in the head and neck region of the body while scrotal skin involvement is rare. We report a case of a 72-year-old man with ulceration of painless scrotal lesions of 10 years' duration. Histology of the wedge biopsies of the lesions was mucinous carcinoma. Clinical workup excluded noncutaneous primary sites of mucinous carcinoma and distant metastasis. He had wide excision of the scrotal skin lesions with histological findings of nests of malignant cells separated from pool of mucin by fibrocollagenous septae. Periodic acid–Schiff stain was positive; however, immunohistochemical stains for estrogen and progesterone receptors were negative. No local recurrence was observed after 12 months of follow-up. Scrotal PCMC is a rare tumor; this may probably be the first reported case of this tumor in the scrotum. Prognosis was good following surgical excision.
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Affiliation(s)
- Olajide Olusegun Abiola
- Department of Surgery, Urology Unit, Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | - Gbemi H Ano-Edward
- Department of Anatomic Pathology, Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | - Olutunde A Oluwumi
- Department of Anatomic Pathology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Mathew E Lasisi
- Department of Anatomic Pathology, Bowen University Teaching Hospital, Ogbomoso, Oyo State, Nigeria
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Lozada KN, Qazi MS, Khorsandi AS, Chai RL. Primary mucinous eccrine carcinoma of the buccal space: A case report and review of the literature. Am J Otolaryngol 2018; 39:242-246. [PMID: 29331306 DOI: 10.1016/j.amjoto.2017.12.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 12/29/2017] [Indexed: 11/30/2022]
Abstract
IMPORTANCE Mucinous eccrine carcinoma is a rare entity that most commonly affects the head and neck. Due to its low frequency of occurrence, review of its etiology, histopathology, and treatment strategies is beneficial to all clinicians who may encounter similar appearing masses. OBSERVATION An 84-year-old male presented with a blue mass on the left cheek. This mass started as a small bump and grew significantly over one year. His primary care physician monitored its growth and ultimately referred to an otolaryngologist. Imaging findings revealed a multi-lobular solid and cystic left buccal lesion. FNA was suggestive of low grade mucoepidermoid carcinoma. INTERVENTION Patient underwent surgical excision with primary closure of the defect. Frozen section was consistent with low grade salivary malignancy. Final pathology revealed primary mucinous eccrine carcinoma of the skin. CONCLUSIONS AND RELEVANCE Mucinous eccrine carcinoma is a rare entity commonly seen in the head and neck region. Mucinous deposits to the skin from primaries elsewhere in the body are much more common than primary lesions of the skin. Histology is a key component of the diagnosis but full oncologic workup is required. Treatment typically includes wide local excision with possible adjuvant chemotherapy or radiation for high risk features.
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Affiliation(s)
- Kirkland N Lozada
- Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States.
| | - Muhammed S Qazi
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Azita S Khorsandi
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Raymond L Chai
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Abstract
BACKGROUND Adnexal carcinomas (ACs) are rare cutaneous malignancies of sweat gland or pilosebaceous origin. Optimal treatment and metastatic potential of AC are poorly defined. Mohs micrographic surgery (MMS) has been increasingly used to treat AC. OBJECTIVE To review selected primary cutaneous AC and their treatment outcomes with MMS. MATERIALS AND METHODS Literature review using PubMed search for articles related to primary cutaneous ACs. RESULTS Sebaceous carcinoma treated with MMS recurred and metastasized in 6.4% and 3.7%, respectively. Primary cutaneous mucinous carcinoma treated with MMS recurred and metastasized in 9.6% and 6.4%, respectively. After MMS, 4.7% of microcystic AC recurred with no reported metastases. After MMS, recurrences and metastases of trichilemmal carcinoma or hidradenocarcinoma have not been reported. Two (4.2%) regional lymph node metastases but no distant metastases or local recurrences have been reported in eccrine porocarcinoma. Squamoid eccrine duct tumor, pilomatrix carcinoma, and spiradenocarcinoma treated with MMS are also reviewed. CONCLUSION The rarity of ACs and the lack of comparative data on treatment makes conclusive recommendations on treatment difficult. Recent large case series and reviews suggest MMS is a useful and possibly superior treatment for AC and should be considered if primary cutaneous disease is suspected.
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11
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Primary mucinous carcinoma of the skin: the Mayo Clinic experience over the past 2 decades. Dermatol Surg 2015; 41:201-8. [PMID: 25627628 DOI: 10.1097/dss.0000000000000198] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Primary mucinous carcinoma of the skin (PMCS) is a rare adnexal eccrine sweat gland neoplasm, often mistaken for metastasis from extracutaneous sites or misdiagnosed. Primary mucinous carcinoma of the skin is a slow-growing tumor with a high recurrence rate after conventional excision. OBJECTIVE To describe clinicopathologic features, rate of recurrence, and metastasis and to review relevant literature. MATERIALS AND METHODS The authors identified patients with PMCS treated from January 1992 through December 2012 at Mayo Clinic. The authors retrospectively reviewed medical records and histology slides. Relevant publications were identified through Ovid MEDLINE and PubMed. RESULTS Six patients with PMCS were identified (1 male). The average age at diagnosis was 63 years. Tumor size ranged from 0.5 to 2.0 cm, and all were confined within the dermis. No evidence of metastatic mucinous adenocarcinoma was documented at the time of diagnosis. Five patients underwent Mohs micrographic surgery, and 1 was treated with wide local excision. There were no episodes of recurrence or metastases after a median follow-up of 20 months (range, 0.5-207 months). CONCLUSION Mohs micrographic surgery may offer reduced recurrence rates and better outcomes in PMCS. Further studies with longer follow-up and bigger cohorts of patients with PMCS are warranted.
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12
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Beteddini OSA, Sheikh S, Shareefi F, Shahab R. Primary mucinous adenocarcinoma of the scalp: A case report and literature review. Int J Surg Case Rep 2015; 10:241-4. [PMID: 25708135 PMCID: PMC4429839 DOI: 10.1016/j.ijscr.2015.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/31/2015] [Accepted: 02/02/2015] [Indexed: 11/04/2022] Open
Abstract
Primary mucinous adenocarcinoma of the skin is a rare tumour. Distinguishing between this primary neoplasm and the more frequently encountered metastatic mucinous deposits on the skin from primaries elsewhere is a diagnostic dilemma. Because of the high rate of recurrence, adequate excision with wide margins is advocated. Moh’s micrographic surgery can be a particularly advantageous treatment modality in this setting. Proper patient counselling and follow-up are important in treating this low-grade, indolent and frequently recurring tumour.
Introduction Primary mucinous adenocarcinoma or mucinous eccrine carcinoma of the skin is a rare malignant neoplasm showing predilection to the head and neck. Distinguishing between these primary neoplasms and the more frequent metastatic mucinous deposits on the skin from primaries in the breast and gastrointestinal tract constitutes a diagnostic dilemma. Presentation of case We report a case of a 61-year-old lady who presented with a slow-growing, painless scalp nodule. Upon excision, it was diagnosed as “primary mucinous adenocarcinoma”. An extensive work-up in search for another primary tumour failed to show a primary malignancy elsewhere and the diagnosis of a primary eccrine mucinous adenocarcinoma of the skin was rendered. Discussion A review of the literature on this entity is presented, discussing diagnostic challenges and therapeutic options that of interest to surgeons, pathologists and dermatologists. Conclusion These tumours are indolent and low-grade, with a tendency for local, sometimes multiple, recurrences. Proper patient counselling and follow-up are important in treatment. Sound collaboration between clinicians and pathologists, for good therapeutic results, is of utmost importance.
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Affiliation(s)
- Osama S Al Beteddini
- Surgery Department, Johns Hopkins Aramco Healthcare/Dhahran Health Center, Saudi Aramco, P.O. Box 76, Dhahran 31311, Eastern Province, Saudi Arabia.
| | - Salwa Sheikh
- Pathology Department, Johns Hopkins Aramco Healthcare/Dhahran Health Center, Saudi Aramco, P.O. Box 76, Dhahran 31311, Eastern Province, Saudi Arabia
| | - Faisal Shareefi
- Surgery Department, Johns Hopkins Aramco Healthcare/Dhahran Health Center, Saudi Aramco, P.O. Box 76, Dhahran 31311, Eastern Province, Saudi Arabia
| | - Rana Shahab
- Dermatology Department, Johns Hopkins Aramco Healthcare/Dhahran Health Center, Saudi Aramco, P.O. Box 76, Dhahran 31311, Eastern Province, Saudi Arabia
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13
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Skin adnexal carcinoma of the head and neck: a retrospective study in a tertiary referral center. Eur Arch Otorhinolaryngol 2014; 272:1001-1010. [DOI: 10.1007/s00405-014-3324-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 10/06/2014] [Indexed: 11/28/2022]
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14
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Miquelestorena-Standley E, Dujardin F, Arbion F, Touzé A, Machet L, Velut S, Guyétant S. Recurrent primary cutaneous mucinous carcinoma with neuroendocrine differentiation: case report and review of the literature. J Cutan Pathol 2014; 41:686-91. [DOI: 10.1111/cup.12347] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 02/05/2014] [Accepted: 03/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Elodie Miquelestorena-Standley
- CHRU de Tours; Laboratoire d'anatomie et cytologie pathologiques; Tours France
- Université François-Rabelais de Tours; PRES Centre-Val de Loire Université; Tours France
| | - Fanny Dujardin
- CHRU de Tours; Laboratoire d'anatomie et cytologie pathologiques; Tours France
| | - Flavie Arbion
- CHRU de Tours; Laboratoire d'anatomie et cytologie pathologiques; Tours France
| | - Antoine Touzé
- INRA; UR 1282, Infectiologie animale et Santé Publique; Nouzilly France
| | - Laurent Machet
- Université François-Rabelais de Tours; PRES Centre-Val de Loire Université; Tours France
- CHRU de Tours; Service de dermatologie; Tours France
| | - Stéphane Velut
- Université François-Rabelais de Tours; PRES Centre-Val de Loire Université; Tours France
- CHRU de Tours; Service de neurochirurgie; Tours France
| | - Serge Guyétant
- CHRU de Tours; Laboratoire d'anatomie et cytologie pathologiques; Tours France
- Université François-Rabelais de Tours; PRES Centre-Val de Loire Université; Tours France
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15
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Dekmezian MS, Cohen PR, Sami M, Tschen JA. Malignancies of the eyelid: a review of primary and metastatic cancers. Int J Dermatol 2013; 52:903-26; quiz 922-3, 926. [DOI: 10.1111/ijd.12089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | | | - Mirwat Sami
- Plastic Eye Surgery Associates; Houston; TX; USA
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16
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Mucinous eccrine carcinoma: a rare case of recurrence with lacrimal gland extension. Ophthalmic Plast Reconstr Surg 2012; 28:e109-10. [PMID: 22327636 DOI: 10.1097/iop.0b013e31823c80ba] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mucinous eccrine carcinoma (MEC) is a rare skin cancer of sweat gland origin with a high rate of recurrence. The most common sites are head and neck, with 40% of cancers found on the eyelid. The clinical appearance and differential diagnosis of MEC are highly varied, but histologically it is similar to metastatic carcinomas, specifically breast and colon. A diagnosis of primary MEC always warrants a full systemic workup to ensure that no other malignancy is present. This cancer is known for frequent recurrences, but rarely metastasizes to distant organs. MEC is resistant to both chemotherapy and radiation; surgical excision remains the treatment of choice in most cases. The authors report a unique case of extension of MEC to the lacrimal gland with a brief review of histologic characteristics of this tumor.
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17
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Chakraborty S, Bonthu N, Swanson BJ, Batra SK. Role of mucins in the skin during benign and malignant conditions. Cancer Lett 2010; 301:127-41. [PMID: 21146919 DOI: 10.1016/j.canlet.2010.11.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 10/31/2010] [Accepted: 11/07/2010] [Indexed: 12/12/2022]
Abstract
Skin-related diseases comprise a major health challenge to the practicing physician, and constitute a significant psychological, social and financial burden to the society. Further, skin cancer, especially non-melanoma skin cancer is currently the leading type of malignancy in the Western world. Given the huge burden of skin diseases, there is growing emphasis on understanding their pathophysiology, and towards their early detection. Mucins are high-molecular weight O- and N-linked glycoproteins that have emerged in recent years as important molecules in maintaining health and in promoting or protecting against inflammation and cancer. They have also begun to emerge as highly specific diagnostic and prognostic markers and novel therapeutic targets in several malignant disorders. However, their role in cutaneous pathologies has remained largely obscured. The present review provides the expression patterns and proposed role of mucins in the healthy skin and various benign and malignant skin diseases. The review has immense clinical significance as the availability of highly specific reagents including monoclonal antibodies against mucins makes them extremely attractive targets for specific diagnosis and/or immunotherapy of benign and malignant cutaneous diseases.
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Affiliation(s)
- Subhankar Chakraborty
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, USA
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18
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Kim JB, Choi JH, Kim JH, Park HJ, Lee JS, Joh OJ, Song KY. A case of primary cutaneous mucinous carcinoma with neuroendocrine differentiation. Ann Dermatol 2010; 22:472-7. [PMID: 21165225 DOI: 10.5021/ad.2010.22.4.472] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 02/02/2010] [Accepted: 03/03/2010] [Indexed: 11/08/2022] Open
Abstract
Primary cutaneous mucinous carcinoma is a rare malignant tumor that originates from the deepest portion of the eccrine sweat duct. Common sites of involvement are the face and scalp. Biopsy shows dermal epithelial cell islands embedded in mucin pools separated by fibrous septae. It is difficult to differentiate this tumor histologically from metastatic adenocarcinoma. Recurrence after excision is common but metastases are rare. We report a primary cutaneous mucinous carcinoma with neuroendocrine differentiation on the right cheek of a 63-year-old man.
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Affiliation(s)
- June-Bum Kim
- Department of Dermatology, Seoul Veterans Hospital, Seoul, Korea
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19
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Scholz IM, Hartschuh W. Primary mucinous eccrine carcinoma of the skin--a rare clinical tumor with many differential diagnoses. J Dtsch Dermatol Ges 2009; 8:446-8. [PMID: 19832929 DOI: 10.1111/j.1610-0387.2009.07291.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Primary mucinous eccrine carcinoma of the skin is an extremely rare tumor most frequently occurring in the face or capillitium. It is felt to be an eccrine carcinoma, characterized by slow progress and unpredictable locally infiltrative growth. Therefore micrographic surgery is important to avoid local recurrence. It can be difficult to differentiate this carcinoma histologically from cutaneous metastases of breast or gastrointestinal tumors. Because of this, a primary staging in affected patients is essential.
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Affiliation(s)
- Ina M Scholz
- Department of Dermatology, University Hospital Heidelberg, Germany.
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20
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Chauhan A, Ganguly M, Takkar P, Dutta V. Primary mucinous carcinoma of eyelid: a rare clinical entity. Indian J Ophthalmol 2009; 57:150-2. [PMID: 19237793 PMCID: PMC2684428 DOI: 10.4103/0301-4738.45509] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Primary cutaneous mucinous carcinoma of the eyelid, a rare pathologic entity, is an adenocarcinoma of the eccrine glands. Though it has low metastatic potential, it does have a significant recurrence rate. We present the occurrence, clinical and histological features, and management of this tumor in a 62-year-old male who presented with a recurrent, firm, nodular left lower lid lesion. He underwent excision with a 5 mm margin and the defect was repaired with a Mustarde's cheek rotation flap. A full oncological screening, including whole-body Positron Emission Tomography scan, excluded the presence of primary mucinous carcinoma elsewhere and any metastatic spread. This case underscores the importance of considering this tumor in recalcitrant eyelid lesions and highlights the pathology of this tumor.
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Affiliation(s)
- Ashutosh Chauhan
- Department of Oncosurgery, Army Hospital (Research and Referral) , Delhi, India.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/therapy
- Carcinoma, Signet Ring Cell/diagnosis
- Carcinoma, Signet Ring Cell/epidemiology
- Carcinoma, Signet Ring Cell/therapy
- Combined Modality Therapy/methods
- Diagnosis, Differential
- Eyelid Neoplasms/diagnosis
- Eyelid Neoplasms/epidemiology
- Eyelid Neoplasms/therapy
- Facial Neoplasms/diagnosis
- Facial Neoplasms/epidemiology
- Facial Neoplasms/therapy
- Humans
- Incidence
- Mycosis Fungoides/diagnosis
- Mycosis Fungoides/epidemiology
- Mycosis Fungoides/therapy
- Prognosis
- Sarcoma, Kaposi/diagnosis
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/therapy
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/therapy
- Sweat Gland Neoplasms/diagnosis
- Sweat Gland Neoplasms/epidemiology
- Sweat Gland Neoplasms/therapy
- Syringoma/diagnosis
- Syringoma/epidemiology
- Syringoma/therapy
- United States/epidemiology
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Affiliation(s)
- Jonathan W Kim
- Department of Ophthalmology, Stanford University Medical Center, Stanford, CA 94304, USA
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22
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Boussofara L, Ghariani N, Yacoubi MT, Denguezli M, Belajouza C, Nouira R. [A large temporal tumor]. Ann Pathol 2008; 28:514-6. [PMID: 19084724 DOI: 10.1016/j.annpat.2007.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2007] [Indexed: 11/18/2022]
Affiliation(s)
- Lobna Boussofara
- Service de Dermatologie, Faculté de Médecine Ibn Jazzar, CHU Farhat-Hached, 4002 Sousse, Tunisie
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23
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24
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Bulliard C, Murali R, Maloof A, Adams S. Endocrine mucin-producing sweat gland carcinoma: report of a case and review of the literature. J Cutan Pathol 2007; 33:812-6. [PMID: 17177942 DOI: 10.1111/j.1600-0560.2006.00545.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Mucinous carcinoma of skin (MCS) is an uncommon adnexal tumor of disputed differentiation. In 1995, Rahilly et al. reported a case of MCS with neuroendocrine differentiation (E-MCS). Since that report, seven additional cases have been published. Here, we report on a case of E-MCS and discuss the differential diagnoses.
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Affiliation(s)
- Carl Bulliard
- Department of Tissue Pathology, Westmead Hospital, The University of Sydney, Westmead, New South Wales, Australia
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25
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Cecchi R, Rapicano V. Primary cutaneous mucinous carcinoma: Report of two cases treated with Mohs' micrographic surgery. Australas J Dermatol 2006; 47:192-4. [PMID: 16867002 DOI: 10.1111/j.1440-0960.2006.00271.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We present a 72-year-old woman who presented with a slowly enlarging, asymptomatic, cystic nodule on the right eyebrow, and a 66-year-old woman who had a reddish, nodular lesion on the left lower eyelid. Incisional biopsy from the two neoplasms showed dermal epithelial cell islands embedded in mucin pools. Tumour cells stained positive for cytokeratin 7, oestrogen and progesterone receptors, and negative for vimentin and S-100 protein. These findings were consistent with a diagnosis of mucinous carcinoma. Extensive work-ups excluded cutaneous metastases from primary visceral mucinous carcinomas. To ensure complete tumour removal, both patients underwent Mohs' micrographic surgery (standard fresh-frozen technique). They remain disease-free 42 and 26 months after surgical excision, respectively. Mohs' micrographic surgery appears to be a rational and effective treatment for this uncommon malignancy.
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Affiliation(s)
- Roberto Cecchi
- Department of Dermatology, Spedali Riuniti, Pistoia, Italy.
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26
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Mitsui H, Watanabe T, Jinnin M, Kadono T, Idezuki T, Tamaki K. Mucinous carcinoma of the skin could have either an eccrine or an apocrine origin. Br J Dermatol 2005; 151:1285-6. [PMID: 15606541 DOI: 10.1111/j.1365-2133.2004.06297.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Abstract
Primary mucinous carcinoma is a rare malignant tumor that most frequently occurs in the periorbital area. This tumor originates from the deepest portion of the eccrine sweat duct. This normally asymptomatic and slow-growing tumor has demonstrated a local recurrence rate of 30% after excision with narrow surgical margins and can have local metastases. It is difficult to differentiate this tumor histologically from metastatic lesions. Immunohistochemical staining and cytokeratin profiles have been studied to aid in the differentiation between primary lesions and metastatic mucinous carcinomas. We present a case of a 54-year-old man with recurrent primary eccrine mucinous carcinoma and review the clinical, histologic, and immunohistochemical features of this tumor.
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28
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Marra DE, Schanbacher CF, Torres A. Mohs Micrographic Surgery of Primary Cutaneous Mucinous Carcinoma Using Immunohistochemistry for Margin Control. Dermatol Surg 2004; 30:799-802. [PMID: 15099329 DOI: 10.1111/j.1524-4725.2004.30223.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Primary cutaneous mucinous carcinoma is a rare adnexal malignancy with a high recurrence rate following conventional excision and the potential for aggressive local invasion. OBJECTIVE To enhance the microscopic detection of mucinous carcinoma in Mohs micrographic surgical sections by incorporating rapid immunohistochemical staining. METHODS Standard Mohs micrographic surgical technique was used in conjunction with frozen section immunohistochemistry using an antibody to low-molecular-weight cytokeratin. RESULTS Rapid immunoperoxidase staining using low-molecular-weight cytokeratin detected residual foci of mucinous carcinoma that were difficult to identify on routine frozen sections. Immunostaining was strongly positive in areas with clear evidence of tumor by routine histology, as well as in adjacent areas on a subsequent stage where frozen sections were equivocal or negative. Immunostaining was distinctly negative at the final surgical margin, which was shown by en face permanent sections to be free of tumor. The patient has been free of recurrence for 3 years. CONCLUSION Immunoperoxidase-guided Mohs micrographic surgery using low-molecular-weight cytokeratin enhances the sensitivity for detection of mucinous carcinoma, and may help contribute to complete tumor removal.
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Affiliation(s)
- Diego E Marra
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, and Mohs Surgery Center, Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA
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29
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Mohs Micrographic Surgery of Primary Cutaneous Mucinous Carcinoma Using Immunohistochemistry for Margin Control. Dermatol Surg 2004. [DOI: 10.1097/00042728-200405000-00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Krishnakumar S, Mohan ER, Babu K, Das D, Biswas J. Eccrine duct carcinoma of the eyelid mimicking meibomian carcinoma: clinicopathological study of a case. Surv Ophthalmol 2003; 48:439-46. [PMID: 12850231 DOI: 10.1016/s0039-6257(03)00050-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Eccrine duct carcinoma belongs to a group of malignant sweat gland tumors showing de novo eccrine differentiation, but without features of benign adnexal counterparts. They are therefore likely to be confused with visceral adenocarcinomas that have metastasized to the lid. These tumors require important diagnostic considerations when adenocarcinoma is encountered in the lid in the absence of a known primary tumor. We present the case of a 60-year-old man with a nodule in the right upper eyelid that was histopathologically diagnosed as eccrine duct carcinoma of the lid. The differential diagnosis of eccrine carcinomas based on light microscopy, enzyme histochemistry, and immunohistochemistry is discussed, and a list of the various malignant eccrine tumors reported in the lid is presented.
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31
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Affiliation(s)
- R W Demetrius
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
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