Malignant Syringoma of the Eyelid

Glatt, Herbert J.; Proia, Alan D.; Tsoy, Edward A.; Fetter, Bernard F.; Neuhaus, Russel; Font, Ramon L.

doi:10.1016/s0161-6420(84)34204-x

Cited by 61 publications

(48 citation statements)

References 17 publications

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“…Briefly, these include sweat gland carcinoma with syringomatous features, malignant syringoma, sclerosing sweat duct carcinoma and syringomatous carcinoma. [2][3][4][5] Clinically, microcystic adnexal carcinoma has a predilection for the head and neck area and is slow growing but locally aggressive. [6][7][8] From a histopathologic perspective, the main differential diagnosis for microcystic adnexal carcinoma, a stratified, infiltrating neoplasm characterized by a superficial component of keratinous cysts and a deeper component of smaller nests and strands of cells embedded in a markedly hyalinized stroma, is sclerosing/infiltrative basal cell carcinoma and desmoplastic trichoepithelioma.…”

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confidence: 99%

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Hoang

Dresser

Kapur³

et al. 2008

Modern Pathology

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Even though immunohistochemical comparisons of microcystic adnexal carcinoma vs infiltrative basal cell carcinoma and desmoplastic trichoepithelioma exist, they are mostly restricted to the use of a single stain. In addition, a comparison with squamous cell carcinoma has not been reported previously. In this study, we compare the expression of cytokeratin (CK) 15, CK7, CK20, CK903, carcinoembryonic antigen (CEA), CD10, CD15 and BerEP4 in 13 microcystic adnexal carcinoma, eight desmoplastic trichoepithelioma, 10 infiltrative basal cell carcinoma, and eight squamous cell carcinoma of which five exhibited ductal differentiation. We found that the majority of microcystic adnexal carcinoma (92%) and desmoplastic trichoepithelioma (100%) cases expressed CK15 while the infiltrative basal cell carcinoma and squamous cell carcinoma cases were all negative. Forty percent of infiltrative basal cell carcinoma expressed CK7; while only two microcystic adnexal carcinoma cases (15%) and one squamous cell carcinoma with ductal differentiation (12%) expressed CK7 in the remaining three tumor categories. None of the desmoplastic trichoepithelioma expressed CK7. All tumors were strongly positive for CK903. While the neoplastic cells were negative, luminal staining of ductal structures was noted for CK7, CD15 and CEA in some of the microcystic adnexal carcinoma, desmoplastic trichoepithelioma and squamous cell carcinoma with ductal differentiation cases. Sixty percent of infiltrative basal cell carcinoma, 31% of microcystic adnexal carcinoma, and 25% of squamous cell carcinoma express CD10. BerEP4 expression was noted in 38% of microcystic adnexal carcinoma, 57% of desmoplastic trichoepithelioma, 100% of infiltrative basal cell carcinoma, and 38% of squamous cell carcinoma. In conclusion, we found CK15 to be a useful marker in distinguishing microcystic adnexal carcinoma from infiltrative basal cell carcinoma and squamous cell carcinoma with ductal differentiation. Our experience indicates that microcystic adnexal carcinoma and desmoplastic trichoepithelioma have a similar immunohistochemical profile that is, CK15 þ and BerEP4 þ /À; thus, additional studies are needed to separate these two entities.

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confidence: 99%

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Hoang

Dresser

Kapur³

et al. 2008

Modern Pathology

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“…Therapy for MACs remains a challenge, as the tumor-free margin is significantly more extensive than can be determined clinically and the tumors exhibit a marked tendency for perineural invasion (3)(4)(5). Numerous treatment modalities have been used to date, including standard excision (SE), MMS, irradiation and chemotherapy (6,16); however, a number of studies have found that MAC is not sensitive to radiotherapy and chemotherapy (5,17). Although the extent of resection using SE is reduced and the technique results in improved esthetics, the tumor recurrence rate is higher.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first report of a MAC in 1982 by Goldstein et al (1), only ~300 cases of MAC have been described to date. MACs are also known as sclerosing sweat duct carcinomas, eccrine epitheliomas and syringomatous carcinomas (4)(5)(6). MACs are most frequently located in the head and neck area (7); however, the occurrence of nasal MACs is extremely rare.…”

Section: Introductionmentioning

confidence: 99%

“…These characteristics complicate the surgical treatment of MAC (8). There are several therapies to treat MAC, including standard excision (SE), Mohs micrographic surgery (MMS), irradiation and chemotherapy (3)(4)(5)(6); however, there is no consensus regarding the treatment of MAC due to its rarity. Furthermore, there is no reported incidence rate of MAC since it is so rare.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Zhou

Zhao

Zhang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Microcystic adnexal carcinoma (MAC) is a rare and locally aggressive adenocarcinoma with low-grade malignancy. The present study describes the first reported case and treatment of a Chinese male with a MAC located on the nasal dorsum and nosewing. A 44-year-old man presented with a nasal deformity caused by local repeated infections following an accidental injury to the nose 20 years previously. The nose had been injured by a brick, and treatment at a local hospital 12 years previously had resulted in a nasal scar and a gradually enlarging mass. A physical examination revealed a hypertrophic deformity of the nose and an indurated scar plaque, measuring 2.0x2.0 cm, on the nasal dorsum and nosewing. Microscopic examination revealed a tumor consisting of solid cell nests and a cystic structure with a capsular space. In addition, ductal cells of an adnexal cell origin were visible in the outer epithelium. The medial portion exhibited a microductal structure and invasion of deeper tissues without evident atypia. The tumor cells presented normal nuclear to cytoplasmic ratios and minimal mitotic activity. Pathological examination verified that the tumor was a MAC of low-grade malignancy. A complete surgical resection was performed via Mohs micrographic surgery (MMS), and reconstruction was achieved using an expanded rotational forehead skin flap. No tumor recurrence was detected after a three-year follow-up period. Therefore, for effective treatment of similar MAC cases, complete surgical resection using MMS is recommended, and successful reconstruction may be achieved using an expanded skin flap.

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“…Duffy et al [16] reported 5 patients with periocular MAC; all located in the lower lid. Glatt et al [22] reported two cases of periocular MAC, both occurring on lower lid. In our series, all but one tumor were located in the medial canthus.…”

Section: Discussionmentioning

confidence: 99%

Periocular Microcystic Adnexal Carcinoma: Management and Outcome with Mohs’ Micrographic Surgery

et al. 2006

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Purpose: To report a series of patients with periocular microcystic adnexal carcinoma (MAC) treated with Mohs’ micrographic surgery (MMS). Design: Prospective, interventional case series. Methods: This series included all patients treated with MMS for periocular MAC, who were monitored by the Skin and Cancer Foundation Australia between 1993 and 2002. Results: There were 5 patients (4 males, 1 female) with a mean age of 52 ± 12 years. Four tumors were located in the medial canthus and one in the lower lid.The tumor was initially misdiagnosed as basal cell carcinoma in 3 patients and squamous cell carcinoma in 1 patient. The average number of excision levels required for complete removal of the tumor during MMS was 2.2 (range 1–6). Perineural invasion was recorded in one patient.Five-year follow-up data was available for 3 patients, and there was no tumor recurrence in any of these cases. Conclusion: The low 5-year recurrence rate of periocular MAC with MMS emphasizes the importance of margin-controlled excision of this tumor.

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Malignant Syringoma of the Eyelid

Cited by 61 publications

References 17 publications

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Periocular Microcystic Adnexal Carcinoma: Management and Outcome with Mohs’ Micrographic Surgery

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