An Immunohistochemical Panel to Differentiate Metastatic Breast Carcinoma to Skin From Primary Sweat Gland Carcinomas With a Review of the Literature

Rollins‐Raval, Marian A.; Chivukula, Mamatha; Tseng, George C.; Jukic, D.M.; Dabbs, David J.

doi:10.5858/2009-0445-oar2

Cited by 90 publications

(66 citation statements)

References 26 publications

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“…For many years, ER, GCDFP-15, and MGB have been considered breast-specific immunomarkers in the workup of tumors of uncertain origin. [63][64][65][66][67] However, the sensitivities for GCDFP-15 and MGB were reported to be in the range of 35% to 55% and 65% to 70%, respectively. Our unpublished data on TMA sections of 250 cases of invasive breast carcinomas, including ductal, lobular, and other special types, were even lower: 30% for GCDFP-15 and 50% for MGB, which is similar to reports by Bhargava et al 64 and by Lewis et al 67 Additionally, MGB was positive in 77% of endometrial ADCs and 31% of endocervical ADCs and other carcinomas as well.…”

Section: Review Of Selected Antibodiesmentioning

confidence: 99%

Immunohistochemistry in Undifferentiated Neoplasm/Tumor of Uncertain Origin

Lin

Liu

2014

Archives of Pathology &Amp; Laboratory Medicine

108

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Context Immunohistochemistry has become an indispensable ancillary study in the identification and classification of undifferentiated neoplasms/tumors of uncertain origin. The diagnostic accuracy has significantly improved because of the continuous discoveries of tissue-specific biomarkers and the development of effective immunohistochemical panels. Objectives To identify and classify undifferentiated neoplasms/tumors of uncertain origin by immunohistochemistry. Data Sources Literature review and authors' research data and personal practice experience were used. Conclusions To better guide therapeutic decisions and predict prognostic outcomes, it is crucial to differentiate the specific lineage of an undifferentiated neoplasm. Application of appropriate immunohistochemical panels enables the accurate classification of most undifferentiated neoplasms. Knowing the utilities and pitfalls of each tissue-specific biomarker is essential for avoiding potential diagnostic errors because an absolutely tissue-specific biomarker is exceptionally rare. We review frequently used tissue-specific biomarkers, provide effective panels, and recommend diagnostic algorithms as a standard approach to undifferentiated neoplasms.

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Section: Review Of Selected Antibodiesmentioning

confidence: 99%

Immunohistochemistry in Undifferentiated Neoplasm/Tumor of Uncertain Origin

Lin

Liu

2014

Archives of Pathology &Amp; Laboratory Medicine

108

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“…The breast location of this tumor and its particular histological findings include in the differential diagnosis a primary breast ductal carcinoma [3], a metastatic clear cell carcinoma [4], an adenomyoepithelioma [5] and primary skin tumors with follicular differentiation, sebaceous differentiation, or sweat gland differentiation [6]. Against a diagnosis of a primary breast ductal carcinoma, there weren't ductular structures around the tumor, cytological atypia was lacking and the neoplastic proliferation had a biphasic cellular population [3]; moreover, mammaglobin, GCDFP15, ER and PR immunohistochemical staining were negative, whereas in a well differentiated breast ductal carcinoma they would expect to be positive.…”

Section: Denmark Discussionmentioning

confidence: 99%

“…Common locations are head, neck and limbs [2]. The histologic appearance put in the differential diagnosis other skin neoplasms and other tumors depending on the location [3][4][5][6]. These tumors are usually benign but they can have rarely low malignant potential, and they should be surgically removed with safety margins, because they have a high local recurrence rate and a potential of malignant transformation [7].…”

Section: Introductionmentioning

confidence: 99%

Recurrent eccrine hidradenoma of the breast in a male patient: problems in differential diagnosis

Orsaria¹,

Mariuzzi²

2013

Our Dermatol Online

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Introduction: Hidradenoma is an uncommon usually benign tumor of the skin that grows slowly. Case report: We describe a case of a 39 patient with a breast mass. Physical examination revealed a solitary, well-circumscribed tumor, measuring 1 cm by 0.7 cm. No other skin abnormalities were found. A total surgical excision was performed and histologic examination concluded to an eccrine hidradenoma with clear cells. Conclusion:Here we discuss problems in the differentiate this tumor, mainly in this not common location, from a breast primary (ductal carcinoma or adenomyoepitelioma), from a metastatic clear cell carcinoma and from other types of skin tumors. Moreover, this patient presented with a recurrence of the tumor in the same location, suggesting a locally aggressive form of this neoplasia; few reports in the literature are described as at low malignant potential, but definite criteria for this diagnosis are not well defined.

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“…This panel consisted in mammoglobin, p63 and three basal cytokeratins (CK5 , CK17 , CK14). The authors recommended the use of this panel to differentiate most cases of sweat gland carcinoma and ductal cutaneous metastases of breast carcinoma which were generally positive for mammoglobin and negative for p63, CK5, CK17 and CK14 [2].…”

Section: Discussionmentioning

confidence: 99%

“…The major differential diagnosis of cutaneous metastatic breast cancer is represented by sweat gland carcinoma which accounts for about 0,05% of all cutaneous neoplasms [1,2]. Treatment and prognoses of these two entities differ radically making accurate histologic diagnosis mandatory.…”

Section: Introductionmentioning

confidence: 99%

How to differentiate mucinous eccrine carcinoma from cutaneous metastasis of breast carcinoma?

Mlika¹,

Boudabbous²,

Ayadi-Kaddour³

et al. 2012

Our Dermatol Online

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IntroductionApproximately 25% of the patients with breast cancer develop cutaneous metastases. The major differential diagnosis of cutaneous metastatic breast cancer is represented by sweat gland carcinoma which accounts for about 0,05% of all cutaneous neoplasms [1,2]. Treatment and prognoses of these two entities differ radically making accurate histologic diagnosis mandatory. Indeed, the presentation of these two entities is often distinct. Cutaneous metastasis of breast carcinoma presents as multiple lesions in patients with a previous diagnosis of primary breast carcinoma, whereas, sweat gland carcinoma presents as a single cutaneous lesion in patients with unknown history of breast cancer. However, cutaneous metastases of breast carcinoma can be difficult to distinguish from sweat gland carcinoma when the diagnosis is based mainly on histologic features and the clinical circumstances are unknown by the pathologist. We describe a new case of sweat gland carcinoma which presented a real diagnostic dilemma. Case ReportA 60-year-old woman presented with a frontal scalp mass which appeared 6 months ago. The patient was asymptomatic and had no history of trauma. Physical examination revealed a painless mass measuring 0.5 cm. Incision biopsy was performed and microscopic findings consisted in a dermal malignant tumor proliferation arranged in clumps and lobules surrounded by an abundant mucoid stroma and separated by thin fibrous septa. Tumor cells were monomorphic, rounded with cytoplasmic vacuoles of mucus secretion and atypical nucleolated nuclei (Fig. 1a, 1b). Immunohistochemical findings showed a nuclear expression of estrogenic and progesteronic antigens (Fig. 1c). Tumor cells didn't express HER2-Neu antigen (Fig. 1d). These microscopic findings were suggestive of a cutaneous metastasis of an eventual mucinous breast carcinoma. A mammography and a chest MRI were performed targeting the primary breast lesion and showed no breast lesion. Facing these radiologic findings, we concluded to a cutaneous mucinous eccrine carcinoma. So that, the lesion was totally resected and the patient presented no complications after one year of follow up.Case Reports DOI: 10.7241/ourd.20124.77 Our Dermatol Online. 2012; 3(4): 346-348Date of submission: 09.07.2012 / acceptance: 09.08.2012 AbstractEccrine skin tumors are rare and represent only 0,05% of all cutaneaous neoplasms. They represent a pitfall especially with cutaneous metastases of carcinoma which are more frequent. We report the case of a 60-year-old woman presented with a frontal scalp mass whose histologic and immunohistochemical features concluded initially to a cutaneous metastasis of breast carcinoma. The diagnosis was reviewed because of the absence of a breast lesion. The final diagnosis was primary sweet gland carcinoma. Histologic distinction between cutaneous metastatic breast carcinoma and primary cutaneous adnexal neoplasms can be very challenging or even impossible. This case illustrates this difficulty and puts emphasis on the necessity of keeping in ...

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An Immunohistochemical Panel to Differentiate Metastatic Breast Carcinoma to Skin From Primary Sweat Gland Carcinomas With a Review of the Literature

Abstract: Together, these 5 IHC stains were combined to make a panel that was 100% sensitive and 91% specific in distinguishing between CMBC and SGC.

Cited by 90 publications

References 26 publications

Immunohistochemistry in Undifferentiated Neoplasm/Tumor of Uncertain Origin

Immunohistochemistry in Undifferentiated Neoplasm/Tumor of Uncertain Origin

Recurrent eccrine hidradenoma of the breast in a male patient: problems in differential diagnosis

How to differentiate mucinous eccrine carcinoma from cutaneous metastasis of breast carcinoma?

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