Clear cell variant of mucoepidermoid carcinoma of the skin

Revercomb, Carolyn H; Reitmeyer, William J.; Pulitzer, Donald R.

doi:10.1016/s0190-9622(08)81871-3

Cited by 17 publications

(18 citation statements)

References 14 publications

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“…26 All but 1 patient with cutaneous MEC was over the age of 50 years at diagnosis. 31 The head and neck region and the acral extremities were the sites of predilection. Judging from the photomicrographs and descriptions, most of the tumors were low-to intermediate-grade MECs.…”

Section: Discussionmentioning

confidence: 99%

Mucoepidermoid Carcinoma of the Skin: A Distinct Entity From Adenosquamous Carcinoma

Riedlinger

Hurley

Dehner

et al. 2005

The American Journal of Surgical Pathology

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Mucoepidermoid carcinoma (MEC) of the skin is an exceedingly rare but distinctive neoplasm with respect to its histopathologic features. It is similar if not identical in most respects to MEC of the salivary gland, a neoplasm whose prognosis is correlated with the pathologic grade. We report a case of MEC of the skin in a 79-year-old white woman who presented with an axillary mass. Beneath an unremarkable epidermis, a circumscribed, cystic neoplasm, unattached to the surface, was characterized by the presence of vague lobules of low-grade-appearing squamous cells accompanied by mucigenic and clear cells. A mucin stain highlighted the mucigenic cells and immunohistochemistry revealed pan-cytokeratin, cytokeratin 7, polyclonal carcinoembryonic antigen, and epithelial membrane antigen positivity. The cytokeratin 20 and gross cystic disease fluid protein were nonreactive. Inconsistency was encountered in the literature where some confusion existed as to whether MEC is synonymous with adenosquamous carcinoma of the skin. Elsewhere in the body, the latter tumor type is a squamous and gland-forming neoplasm with intermediate- to high-grade features rather than a tumor with mucigenic cells intermingled among intermediate and squamous cells. As in the case of MEC and adenosquamous carcinoma elsewhere in extracutaneous sites, we would propose that a pathologic distinction should be made in the skin for the sake of consistency and for prognostic purposes. Additionally, the immunophenotype of our case is similar to at least two other cases of cutaneous MEC, as well as MEC of the salivary gland, to support the hypothesis that this neoplasm is adnexal rather than epidermal in origin.

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Section: Discussionmentioning

confidence: 99%

Mucoepidermoid Carcinoma of the Skin: A Distinct Entity From Adenosquamous Carcinoma

Riedlinger

Hurley

Dehner

et al. 2005

The American Journal of Surgical Pathology

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“…4 Primary cutaneous MECs are exceptionally rare with only 11 cases reported in the medical literature. [5][6][7][8][9][10][11][12][13][14][15] Much confusion exists about the terminology of this neoplasm because many reports have used indiscriminately the terms mucoepidermoid and adenosquamous to designate cutaneous neoplasms showing glandular and squamous differentiation. 7,16,17 Differential diagnosis is not only academic because they show very different biological behaviors: MEC is usually a low-grade neoplasm with limited metastatic potential, whereas adenosquamous carcinoma (ASC) is a high-grade neoplasm prone to local recurrence and metastatic dissemination.…”

Section: Introductionmentioning

confidence: 99%

Primary Mucoepidermoid Carcinoma of the Skin Expressing p63

Suárez-Peñaranda¹,

Vieites²,

Valeiras³

et al. 2010

The American Journal of Dermatopathology

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Primary mucoepidermoid carcinoma (MEC) of the skin is an unusual neoplasm with few cases reported in the English medical literature. It has to be differentiated from adenosquamous carcinoma, usually a high-grade neoplasm with poorer outcome, and metastasis from a primary MEC arising elsewhere in the body. We report a 78-year-old woman with an abdominal skin lesion of recent onset. Histopathological examination revealed a dermal located carcinoma with variable proportions of squamous differentiation and goblet cells. The patient died in a very short time for an unrelated disease. Immunohistochemical study showed staining for cytokeratins (AE1AE3, 7, and 34betaE12), epithelial membrane antigen (EMA), and p63, whereas cytokeratins 18 and 20 and gross cystic disease fluid protein (GCDFP15) were negative. We conclude that primary MEC of the skin is usually a slow-growing neoplasm that should be differentiated from adenosquamous carcinoma. The immunohistochemical staining for p63 is helpful to differentiate primary and metastatic MEC in the skin.

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“…[241][242][243] Clear cell change may be seen. 247 Unlike the adenoid cystic carcinoma, perineural infiltration is rare. 143 Cytologic atypia is inconspicuous, with round to oval nuclei in the 10-15-mm size range, showing little if any apoptosis and typically no mitoses.…”

Section: Histopathologymentioning

confidence: 99%

“…[241][242][243] Like adenoid cystic carcinoma in salivary gland tissue, the mucoepidermoid carcinomas in that tissue anlage tends to show multiple local recurrences and only uncommonly distant metastases; in such a scenario, the clinical history provides definitive proof. [244][245][246][247] Mucoepidermoid carcinoma has been reported to arise in a nevus sebaceus of Jadassohn. 248 As is the case with many of the adnexal carcinomas, Mohs microsurgery had been advocated in the treatment of mucoepidermoid carcinoma of the skin.…”

Section: Introduction and Clinical Featuresmentioning

confidence: 99%

Malignant adnexal neoplasms

2006

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Malignant cutaneous adnexal neoplasms are one of the most challenging areas of dermatopathology. Tumors of the pilosebaceous apparatus can occur as single-lineage neoplasms or may manifest as complex proliferations with multilineal differentiation patterns including not only the germinative component of the hair bulb, the inner or outer root sheath epithelium and the sebaceous gland and duct, but also the sweat duct components that relate to the apocrine secretory apparatus which empties into the follicle near the follicular bulge. Eccrine and apocrine neoplasms present a bewildering array of morphologies, which often defy precise classification. The purpose of this review is to discuss in detail the malignant neoplasms of the cutaneous adnexae and their benign and prognostically indeterminate mimics. Modern Pathology (2006) 19, S93-S126. doi:10.1038/modpathol.3800511Keywords: eccrine carcinoma; sebaceous neoplasia Malignant tumors of the pilosebaceous apparatus, their mimics and precursors IntroductionTumors of the pilosebaceous unit can occur in isolation or in combination with complex proliferations showing multilineal differentiation patterns encompassing those of sweat ducts, epidermis and stroma with its varied components. In this review, we will focus upon the malignant adnexal proliferations, considering benign entities mainly insofar as they impact the diagnostic approach to adnexal carcinoma. We will first turn to the malignant sebaceous neoplasms, their precursors and their mimics. Sebaceous adenoma Clinical FeaturesThe sebaceous adenoma is a benign neoplasm that manifests clinically as a pale yellow nodular lesion, typically of the face, that expresses itself clinically after the age of 50. Tumors range in size from o1 to 45 cm. [1][2][3][4][5][6] These lesions are associated with the Muir-Torre syndrome, comprising the coexpression of cutaneous neoplasms, including those of sebaceous type with well-differentiated squamous epithelial neoplasms, and visceral malignancies, including carcinomas of the breast, ovary, gastrointestinal tract and larynx. [7][8][9][10][11][12][13][14] An occasional patient may manifest a malignant lymphoma of nodal or extranodal type. 10,12,14 Sebaceous neoplasms in the setting of Muir-Torre syndrome are often difficult to classify, showing overlap features between all of the prototypic forms of sebaceous neoplasm ranging from hyperplasia to carcinoma. 13 HistologyThe prototypic sebaceous adenoma manifests 1-2 layers of germinitive cells which mature to form central sebocytes, and have an architecture comprising a sharply circumscribed sebaceous lobule surrounded by a compressed pseudocapsule of dermal stroma ( Figure 1a). The overlying epidermis may be attenuated, but sometimes forms a collarette around the peripheral aspect of the neoplasm. Unlike sebaceous hyperplasia, occasional mitoses may be seen in the lobules of a sebaceous adenoma and in concert with this nucleoli may be somewhat prominent, but the pleomorphism, hyperchromasia and individual cell necrosis of the se...

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Clear cell variant of mucoepidermoid carcinoma of the skin

Cited by 17 publications

References 14 publications

Mucoepidermoid Carcinoma of the Skin: A Distinct Entity From Adenosquamous Carcinoma

Mucoepidermoid Carcinoma of the Skin: A Distinct Entity From Adenosquamous Carcinoma

Primary Mucoepidermoid Carcinoma of the Skin Expressing p63

Malignant adnexal neoplasms

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