A clinical, pathological and immunohistochemical series of 9 cases of primary cutaneous apocrine carcinomas of the head and neck

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 followup 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.

Treatment of Malignant Adnexal Tumors of the Skin: A 12-Year Perspective

“…Lee et al reported a case of a patient with metastatic porocarcinoma who achieved a clinical and radiological response when treated with pembrolizumab [ 52 ]. For hidradenocarcinoma, apocrine carcinoma, and signet-ring call/histiocytoid carcinoma, HER2 inhibitors or selective estrogen receptor modulators may be administered [ 53 , 54 , 55 , 56 , 57 , 58 ]. Additionally, anti-androgenic therapy is beneficial for patients with signet-ring call/histiocytoid carcinoma [ 59 ].…”

Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation

“…Only a few adnexal malignancies show a favorable prognosis, and no cases of recurrent or metastatic disease were reported [183,189,193,195]. [151,[154][155][156]321] A: 45-70 [151] Squamoid eccrine ductal carcinoma R ND [162,322] ND [161,162,322] Syringocystadenocarcinoma papilliferum R LD [170,172] LD [170][171][172] Secretory carcinoma R ND [183] ND [183] Cribriform carcinoma R ND [189,190,193] ND [189,193] Signet-ring cell/histiocytoid carcinoma R NA, A-conventional and targeted therapy (HER2 inhibitors, tamoxifen, anti-androgen) [23,197,199,204] NA, A [24,197,199,203,204] Hidrocystoma/cystadenoma R ND ND In a recent single-institution experience report, the median overall survival (OS) was 158 months (95% CI, . Age > 60 years was an unfavorable predictor of OS (HR 12.9, p < 0.0008) and recurrence-free survival (RFS) (HR 12.53, p < 0.0003).…”

“…Morabito et al reported a case of recurrent disease previously treated with surgery, radiotherapy, and chemotherapy (Al-Saraff schedule). The patient responded to a second-line systemic chemotherapy regimen consisting of methotrexate and bleomycin [ 155 ]. HER2 inhibitors (tanstuzumab) are also used [ 156 , 157 ].…”

Ex vivo analysis of DNA repair targeting in extreme rare cutaneous apocrine sweat gland carcinoma

“…In context of the primary diagnosis of the patient’s tumor as a metastatic cutaneous apocrine sweat gland carcinoma (CAC), the immunohistochemistry profile of the tumor tissue had been AR + . ER + , PR - , HER2 - , CK7 + [ 4 ]. GCDFP15 - and mammaglobin - (SCGB2A2) [ 5 ] with Ki67 index of 40%.…”

“…Metastatic cutaneous apocrine gland carcinoma (CAC) is an extreme rare malignancy arising from a sweat gland with < 30 reported cases in the literature [ 1 – 3 ]. Majority of these reported cases are derived from the axilla with only a few cases originating from other regions of the integumentary system [ 4 ]. The tumorigenesis of these rare cancers is largely unclear, but histologically cutaneous apocrine gland carcinomas mimic metastatic apocrine breast cancer or apocrine carcinomas arising in ectopic breast tissue [ 5 , 6 ].…”