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Kim JW, Shin JW, Huh CH. Primary Cutaneous Apocrine Carcinoma and Syringocystadenoma Papilliferum Arising in Nevus Sebaceus: A Case Report and Review of the Literature. Ann Dermatol 2023; 35:S4-S9. [PMID: 37853855 PMCID: PMC10608364 DOI: 10.5021/ad.21.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 10/20/2023] Open
Abstract
Nevus sebaceus is a hamartomatous lesion characterized by epidermal, follicular, sebaceus, and apocrine gland abnormalities. Approximately 25% of affected individuals may develop benign or malignant secondary neoplasms within the preceding nevus sebaceus. Primary cutaneous apocrine carcinoma (PCAC) is a rare malignant skin tumor affecting elderly adults in their sixth decade of life. Histologically, PCAC appears as a dermal tumor displaying apocrine differentiation with decapitation secretion and malignant features. Secondary malignancy arising from nevus sebaceus is a rare complication, especially for apocrine carcinoma. To date, approximately 200 cases of PCAC have been reported in the literature, and only a few cases have developed PCAC on the scalp. Very few cases (approximately only 12) of PCACs developing in nevus sebaceus have been reported. Here, we report an extremely rare case of the coexistence of PCAC and syringocystadenoma papilliferum arising within nevus sebaceus of the scalp.
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Affiliation(s)
- Jee Woo Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.
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Choi JH, Oh HM, Kim KS, Choi YD, Joo SP, Hwang WJ, Hwang JH, Lee SY. Primary cutaneous apocrine carcinoma of the scalp: Two case reports and literature review. Medicine (Baltimore) 2022; 101:e28808. [PMID: 35147116 PMCID: PMC8830877 DOI: 10.1097/md.0000000000028808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/25/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Apocrine carcinoma is a rare malignant sweat gland tumor that has been reported in approximately 200 cases. This tumor usually occurs in the axilla, but in rare cases, it can also develop in the scalp. In the present work, we report 2 cases of cutaneous apocrine carcinoma of the scalp. PATIENT CONCERNS Two men visited our outpatient clinic with recurrence of tumor after undergoing surgery for scalp tumor at another hospital. DIAGNOSES Brain magnetic resonance imaging of a 56-year old man showed the presence of a 5.0 × 4.5 × 4.4 cm scalp mass in the right parietal region, invading the skull and dura mater and a 2.2 × 2.0 × 0.7 cm bony mass without any skin lesions right next to the scalp mass. Neck magnetic resonance imaging of a 76-year-old man revealed the presence of a well-defined oval mass in the subcutaneous layer of the left occipital scalp and 2 enlarged lymph nodes in the left neck. Definite diagnoses were made postoperatively. The patients were diagnosed with cutaneous apocrine carcinoma. The diagnosis was confirmed through histopathological and immunohistochemical staining tests. INTERVENTIONS The tumors were removed with a wide safety margin and reconstructive surgery was performed. OUTCOMES Additional radiotherapy or chemotherapy was performed. Follow-up more than 6 months revealed no recurrence or metastasis. LESSONS If accurate diagnosis and treatment had taken place at the initial stages of the primary cutaneous apocrine carcinoma, it would have been possible to prevent recurrence and intracranial invasion. As recurrent primary cutaneous apocrine carcinoma can become aggressive and difficult to treat, even a small mass on the scalp must be evaluated carefully and treated properly.
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Affiliation(s)
- Jun Ho Choi
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Hyun Myung Oh
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kwang Seog Kim
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Sung Pil Joo
- Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Won Joo Hwang
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jae Ha Hwang
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Sam Yong Lee
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
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Płachta I, Kleibert M, Czarnecka AM, Spałek M, Szumera-Ciećkiewicz A, Rutkowski P. Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation. Int J Mol Sci 2021; 22:5077. [PMID: 34064849 DOI: 10.3390/ijms22105077] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary treatment, affecting their outcome. The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors.
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Sekine C, Kawase K, Yoshida K. Sentinel lymph node biopsy of primary apocrine sweat gland carcinoma of the axilla: A case report and review of the literature. Int J Surg Case Rep 2020; 77:122-125. [PMID: 33160170 PMCID: PMC7649587 DOI: 10.1016/j.ijscr.2020.10.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/17/2020] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Chikako Sekine
- Department of Surgery, The Jikei University School of Medicine Katsushika Medical Center, 6-41-2 Aoto, Katsushika Ward, Tokyo 125-8506, Japan; Department of Breast Surgery, International University of Health and Welfare, Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan.
| | - Kazumi Kawase
- Department of Surgery, The Jikei University School of Medicine Katsushika Medical Center, 6-41-2 Aoto, Katsushika Ward, Tokyo 125-8506, Japan
| | - Kazuhiko Yoshida
- Department of Surgery, The Jikei University School of Medicine Katsushika Medical Center, 6-41-2 Aoto, Katsushika Ward, Tokyo 125-8506, Japan
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Al-Hakami H, Awad BI, Al-Garni M, Al-Maghrabi HA, Al-Shareef N. Apocrine carcinoma of the scalp with neck lymph node metastasis: A case report and review of the literature. J Family Med Prim Care 2019; 8:3758-3762. [PMID: 31803688 PMCID: PMC6881922 DOI: 10.4103/jfmpc.jfmpc_833_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 09/27/2019] [Accepted: 10/13/2019] [Indexed: 11/12/2022] Open
Abstract
Primary cutaneous apocrine carcinoma (PCAC) is an extremely rare malignancy. Distinguishing apocrine carcinoma from breast carcinoma metastasis is difficult. Only a few cases reported as PCAC of the scalp and primarily treated by wide local excision. The usual presentation is a skin lesion that rapidly progresses over the duration of a few weeks to few months. We reported a 56-year-old man with a right scalp ulcerative lesion diagnosed as a CAC. The patient underwent wide local excision. 1.5 years later, the patient developed neck lymph node metastasis that treated with neck dissection and adjuvant radiotherapy. No chemotherapy was given due to limited literature, suggesting substantial benefits of adjuvant chemotherapy for such cases. Review literature was performed to assess the clinical presentation, treatment, and prognosis of such malignancies. PCAC of the scalp is a challenging malignancy in the diagnosis and management.
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Affiliation(s)
- Hadi Al-Hakami
- Department of Otolaryngology-Head and Neck Surgery, King Abdullah International Medical Research Center, National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Baraa I Awad
- Department of Otolaryngology-Head and Neck Surgery, King Abdullah International Medical Research Center, National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohammed Al-Garni
- Department of Otolaryngology-Head and Neck Surgery, King Abdullah International Medical Research Center, National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Haneen A Al-Maghrabi
- Department of Anatomic Pathology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Noura Al-Shareef
- Department of Otolaryngology-Head and Neck Surgery, King Abdullah International Medical Research Center, National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Gatti AP, Tonello L, Pfaffenzeller W, Savóia FO, Goergen DI, De Pieri Coan R, Teixeira UF, Waechter FL, Fontes PRO. Apocrine sweat gland adenocarcinoma: A rare case report and review. Int J Surg Case Rep 2017; 36:78-81. [PMID: 28550787 PMCID: PMC5447375 DOI: 10.1016/j.ijscr.2017.04.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 04/26/2017] [Accepted: 04/30/2017] [Indexed: 11/17/2022] Open
Abstract
Apocrine Sweet Gland Adenocarcinoma is a very uncommon cancer that can cause structural deformities by metabolic disorder (paraneoplastic syndrome). That’s the first case related on Brazil. This case contributes to the best choice of the exams required for detection of this rare cancer (there is no consensus in the literature by the limited number of cases).
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.
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Affiliation(s)
- Arthur Paredes Gatti
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil.
| | - Luiza Tonello
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - William Pfaffenzeller
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Fernando Oliveira Savóia
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Diego Inácio Goergen
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Rodrigo De Pieri Coan
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Uirá Fernandes Teixeira
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Fábio Luiz Waechter
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Paulo Roberto Ott Fontes
- Departament of Surgery, Universidade Federal De Ciências Da Saúde De Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
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Kshirsagar AY, Wader JV, Nagur B, Biradar S, Savsaviya J, Chotai T, Agarwal A. Case report: A rare case of eccrine carcinoma. Int J Surg Case Rep 2015; 15:149-51. [PMID: 26367319 PMCID: PMC4601981 DOI: 10.1016/j.ijscr.2015.08.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 08/25/2015] [Indexed: 11/18/2022] Open
Abstract
Sweat gland carcinoma is very rare with a reported incidence of less than 0.005% of all tumour specimens resected surgically. Due to limited availability of literature, the diagnosis as well as management of these tumours is quite difficult. Presented to us with a solitary swelling over the left chest wall since two month. We managed the case with wide excision of the swelling with segmental excision of the involved segments of the ribs with pleura followed by a Delto-Pectoral fasciocutaneous flap with insertion of an intercostal drain. Histopathology report confirmed an eccrine carcinoma with involvement of the ribs. The tumour cells immunohistochemical study showed that tumour cells were positive for pancytokeratin/CK7/Calretinin with focal luminal immunoreactivity for CEA.
Introductions Sweat gland carcinoma is very rare with a reported incidence of less than 0.005% of all tumour specimens resected surgically (Tulenko and Conway, 1965) [1]. Case report A sixty year old male patient presented to us with a solitary swelling over the left chest wall since two months. Discussion Cutaneous apocrine gland carcinoma, a subtype of sweat gland carcinoma, is a very rare malignant neoplasm arising in areas of high apocrine sweat gland density. The variability of the histological features even in the same tumour, and its rarity, have contributed to some confusion regarding the classification of sweat gland carcinoma. Conclusions Sweat gland carcinomas are a rare group of tumours with potential for local destruction as well as distant metastasis. Wide surgical excision along with regional lymph node dissection in the presence of clinically positive nodes is the recommended treatment. However, a frequent follow up is essential to detect early recurrence as well as distant metastasis.
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Affiliation(s)
- Ashok Y Kshirsagar
- Department of Surgery, Krishna Institute Of Medical Sciences, Karad, Maharashtra 415110, India.
| | - J V Wader
- Department of Pathology, Krishna Institute Of Medical Sciences, Karad, Maharashtra 415110, India
| | - Basavaraj Nagur
- Department of Surgery, Krishna Institute Of Medical Sciences, Karad, Maharashtra 415110, India
| | - Sangeeta Biradar
- Department of Surgery, Krishna Institute Of Medical Sciences, Karad, Maharashtra 415110, India
| | - Jigneshkumar Savsaviya
- Department of Surgery, Krishna Institute Of Medical Sciences, Karad, Maharashtra 415110, India
| | - Trishant Chotai
- Department of Surgery, Krishna Institute Of Medical Sciences, Karad, Maharashtra 415110, India
| | - Aman Agarwal
- Department of Surgery, Krishna Institute Of Medical Sciences, Karad, Maharashtra 415110, India
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Gupta E, Guthrie KJ, Krishna M, Asmann Y, Parker AS, Joseph RW. Whole exome sequencing of a patient with metastatic hidradenocarcinoma and review of the literature. Rare Tumors 2015; 7:5719. [PMID: 25918615 PMCID: PMC4387361 DOI: 10.4081/rt.2015.5719] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 12/16/2022] Open
Abstract
Hidradenocarcinoma is a rare malignancy of the sweat glands with only a few cases reported in literature. The management of these tumors is based on the extent of disease with local disease managed with surgical resection. These can tumors carry a high potential of lymphatic and vascular spread and local and distant metastases are not uncommon. Given the rarity of the tumor and lack of genetic and clinical data about these tumors, there is no consensus on the proper management of metastatic disease. Here in we report the first case of metastatic hidradenocarcinoma with detailed molecular profiling including whole exome sequencing. We identified mutations in multiple genes including two that are potentially targetable: PTCH1 and TCF7L1. Further work is necessary to not only confirm the presence of these mutations but also to confirm the clinical significance.
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Affiliation(s)
- Eva Gupta
- Division of Hematology and Oncology, Mayo Clinic , Jacksonville, FL, USA
| | | | - Murli Krishna
- Department of Pathology/Lab Medicine, Mayo Clinic , Jacksonville, FL, USA
| | - Yan Asmann
- Division of Cancer Biology, Mayo Clinic , Jacksonville, FL, USA
| | - Alexander S Parker
- Departments of Health Sciences Research and Medicine, Mayo Clinic , Jacksonville, FL, USA
| | - Richard W Joseph
- Division of Hematology and Oncology, Mayo Clinic , Jacksonville, FL, USA
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Figueira EC, Danks J, Watanabe A, Khong JJ, Ong L, Selva D. Apocrine Adenocarcinoma of the Eyelid: Case Series and Review. Ophthalmic Plast Reconstr Surg 2013; 29:417-23. [DOI: 10.1097/iop.0b013e3182a64fe5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Falkenstern-Ge RF, Bode-Erdmann S, Ott G, Wohlleber M, Kohlhäufl M. Late lung metastasis of a primary eccrine sweat gland carcinoma 10 years after initial surgical treatment: the first clinical documentation. Case Rep Oncol Med 2013; 2013:167585. [PMID: 23710393 DOI: 10.1155/2013/167585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 04/07/2013] [Indexed: 11/17/2022] Open
Abstract
Background. Sweat gland carcinoma is a rare malignancy with a high metastatic potential seen more commonly in elderly patients. The scalp is the most common site of occurrence and it usually spreads to regional lymph nodes. Liver, lungs, and bones are the most common sites of distant metastasis. Late lung metastasis of sweat gland adenocarcinoma after a time span of 5 years is extremely rare. Aim. We report a patient with late lung metastasis of a primary sweat gland carcinoma 10 years after initial surgical resection. Conclusion. Sweat gland carcinomas are rare cancers with a poor prognosis. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Late pulmonary metastases with a latency of 10 years have never been reported in the literature. This is the first clinical documentation of late lung metastasis from sweat gland carcinoma with a latency period of 10 years.
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Affiliation(s)
- Elisa Gallerani
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Michele Ciriolo
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Chiara Rossini
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Franco Cavalli
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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Roy S, Shafi NQ, Rose MG. Locally recurrent and metastatic apocrine-gland carcinoma in an elderly man. ACTA ACUST UNITED AC 2007; 4:56-9. [PMID: 17183356 DOI: 10.1038/ncponc0694] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 08/11/2006] [Indexed: 11/08/2022]
Abstract
BACKGROUND A 78-year-old man with a history of untreated hypertension and dementia presented with a rapidly growing, painful mass in the left axilla. He was a nonsmoker and did not consume alcohol. There was no family history of malignancy. The patient had not experienced any constitutional symptoms, such as fever, weight loss, night sweats, or loss of appetite. INVESTIGATIONS Physical examination, blood tests, excisional biopsy, studies of tumor morphology and immunohistochemistry, CT of the chest and abdomen, and PET scan. DIAGNOSIS Carcinoma of the axillary apocrine gland. MANAGEMENT Surgical excision, and radiation therapy.
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Affiliation(s)
- Shailja Roy
- Section of Medical Oncology, Yale University School of Medicine, New Haven, CT, USA
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Kycler W, Korski K, Łaski P, Wójcik E, Bręborowicz D. Metastatic apocrine adenocarcinoma of the axillary area. Rep Pract Oncol Radiother 2006. [DOI: 10.1016/s1507-1367(06)71076-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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14
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Shimato S, Wakabayashi T, Mizuno M, Nakahara N, Hatano H, Natsume A, Ishii D, Hasegawa Y, Hyodo I, Nagasaka T, Yoshida J. Brain metastases from apocrine carcinoma of the scalp: case report. J Neurooncol 2005; 77:285-9. [PMID: 16314948 DOI: 10.1007/s11060-005-9039-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Accepted: 09/02/2005] [Indexed: 10/25/2022]
Abstract
Apocrine carcinoma is an extremely rare malignant neoplasm that occurs most frequently in the axilla. Although it usually shows an indolent clinical course, it often metastasizes to regional lymph nodes and sometimes to lungs or bones. However, a literature search did not reveal any report describing the detailed clinical course of brain metastases from apocrine carcinoma. We report a case of a 54-year-old male who suffered from multiple brain metastases from apocrine carcinoma that had originated in the scalp 6 years before. The brain metastases appeared in spite of several regimens of chemotherapy for lung metastases for two years. The tumor in the right frontal lobe was successfully operated. However, the small tumor in the right occipital lobe was not cured by gamma knife surgery, and eventually required second operation. The operation had contributed to his neurologically independent life for about one year until he died for gradual progression of lung metastases. To our knowledge this is the first reported case of metastatic brain tumor from apocrine carcinoma.
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Affiliation(s)
- Shinji Shimato
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan.
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Abstract
The objectives of this paper are to report a case of apocrine carcinoma and the discussion of aspects related to its diagnosis, treatment, and prognosis. Carcinomas with apocrine differentiation not related to extramammary Paget's disease, ductal breast carcinoma, Moll's glands adenocarcinoma and ceruminous glands carcinoma are very uncommon tumors. We report a case of a 51-year-old black woman who developed apocrine carcinoma lesions in the head and neck region. Two lesions involved her left parotid gland (first tumor and local recurrence), and other involved her submandibular skin. The microscopic aspects were as follows: infiltrative glandular epithelial neoplasm with moderate cellular and nuclear pleomorphism; neoplasic cells with polygonal or circular shape, large nuclei and eosinophilic and granular cytoplasm. The apical decapitation secretion was viewed in a large number of intra-cystic tumor cells. Moreover, we found areas with comedo-necrosis or PAS positive staining (with or without diastase). Based on cutaneous apocrine carcinoma compatibility of the microscopic aspects, we concluded that the tumor in the submandibular skin was probably the primary neoplasm. The patient was treated by surgical excisions, and no evidence of recurrent or metastatic disease has been seen after a follow-up period of 12 months.
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