Microcystic adnexal carcinoma: Collaborative series review and update

Friedman, Paul M.; Friedman, R; Jiang, Steve B; Nouri, Keyvan; Amonette, Rex A.; Robins, Perry

doi:10.1016/s0190-9622(99)70053-8

Cited by 148 publications

(171 citation statements)

References 31 publications

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“…[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. In addition, we noticed misdiagnosis of a few cases of microcystic adnexal carcinoma as squamous cell carcinoma at our institution-most likely a consequence of the biopsy technique (superficial shave).…”

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confidence: 99%

“…While local recurrence is reported in 50% of cases of microcystic adnexal carcinoma with positive margins, 40-60% of patients experience one or more local recurrences anywhere from 6 months to 30 years after standard wide local excision. 4,6,7,[9][10][11] Thus, while the standard of care for microcystic adnexal carcinoma is wide local excision, no further management is mandated for a desmoplastic trichoepithelioma.…”

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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%

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confidence: 99%

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Hoang

Dresser

Kapur³

et al. 2008

Modern Pathology

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“…Microcystic adnexal carcinoma (MAC) is a rare neoplasm that most often arises in the central facial skin of middleaged and older adults [1][2][3][4][5][6]. It is most common among Caucasians and shows a slight female predominance.…”

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confidence: 99%

“…This infiltrative pattern corresponds with their clinical behavior: MACs characteristically show extensive invasion and local destruction and are prone to recurrence. This insidious, locally-aggressive course necessitates lifetime monitoring for and management of recurrence even after resection and therapy [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Sclerosing Microcystic Adenocarcinoma of the Head and Neck Mucosa: A Neoplasm Closely Resembling Microcystic Adnexal Carcinoma

Mills

Policarpio-Nicholas

Agaimy

et al. 2016

Head and Neck Pathol

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Microcystic adnexal carcinoma (MAC) occurs predominantly in the centrofacial skin and has been only rarely reported in mucosal surfaces. We here present a 5 case series of tumors closely resembling MAC occurring in the mucosal surfaces of the head and neck, which we have termed sclerosing microcystic adenocarcinomas. These tumors showed a predilection for women (4:1) with an average patient age of 52.6 years (range 41-73 years). Location included the tongue (n = 2), the floor of the mouth (n = 2), and the nasopharynx/clivus (n = 1). One occurred after radiation therapy and another occurred in the setting of immune compromise. Immunohistochemistry highlighted a dual cell population with luminal cells showing positivity for high and low-molecular weight keratins and surrounding myoepithelial cells showing S100 and smooth muscle actin staining. No cases had nodal involvement, and the single patient with clinical follow-up was alive and free of disease 34 months after diagnosis and definitive radiochemotherapy. Differential diagnoses for all cases diverged from those provoked by MAC in the skin and included a variety of salivary gland neoplasms such as adenoid cystic carcinoma, polymorphous low grade adenocarcinoma, and mucoepidermoid carcinoma. Recognition of sclerosing microcystic adenocarcinoma in the head and neck mucosa is critical given its bland appearance and subtle infiltration pattern, infrequency of nodal involvement, and behavioral differences from the other entities on the differential.Keywords Sclerosing microcystic adnexal carcinoma Á Microcystic adnexal carcinoma Á MAC Á Head and neck Á Salivary gland carcinoma Á Mucosal

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“…Local recurrence rates are approximately 50%. [210][211][212][213][214] Occasionally, the lesion will appear in unusual locations and settings, such a recent case arising in the external auditory canal 15 years after radiotherapy of a nasopharyngeal carcinoma that had occurred in a 12-year boy. 215 Another patient showed the synchronous development of a microcystic adnexal carcinoma with a gastric carcinoma.…”

Section: Introductionmentioning

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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Microcystic adnexal carcinoma: Collaborative series review and update

Cited by 148 publications

References 31 publications

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Sclerosing Microcystic Adenocarcinoma of the Head and Neck Mucosa: A Neoplasm Closely Resembling Microcystic Adnexal Carcinoma

Malignant adnexal neoplasms

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