Microcystic adnexal carcinoma of the skin: The role of adjuvant radiotherapy

Baxi, Siddhartha; Deb, Siddhartha; Weedon, David; Baumann, Kacy; Poulsen, Michael

doi:10.1111/j.1754-9485.2010.02200.x

Cited by 34 publications

(43 citation statements)

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“…Stein et al . suggested that definitive radiotherapy for adnexal carcinomas has resulted in a clinically aggressive transformation which we cannot comment on in our study as none of the patients received radical radiotherapy; however, one patient who did not have radiotherapy post-tumor resection developed locoregional recurrence [11, 12]. …”

Section: Discussionmentioning

confidence: 99%

Retrospective study of rare cutaneous malignant adnexal tumors of the head and neck in a tertiary care cancer hospital: a case series

et al. 2017

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BackgroundAdnexal tumors of the skin are a large and diverse group of benign and malignant neoplasms, which exhibit morphological differentiation toward one of the different types of adnexal epithelium present in normal skin and they pose a diagnostic challenge. The purpose of this study is to share our experience with these rare but aggressive tumors at a tertiary care cancer hospital in a developing country. A retrospective review of 11 patients diagnosed with rare adnexal tumors and their variants from January 2005 to December 2014, treated either surgically or non-surgically, was performed to describe the clinicopathological characteristics and outcome of the disease.Case presentationA total of 11 patients were diagnosed with adnexal carcinoma and its variants: a 34-year-old Sindhi man, a 59-year-old Punjabi woman, a 32-year-old woman from Khyber Pakhtunkhwa, a 43-year-old Punjabi woman, a 64-year-old Punjabi man, a 51-year-old man from Khyber Pakhtunkhwa, a 51-year-old Punjabi woman, a 74-year-old Punjabi woman, a 75-year-old Punjabi man, a 61-year-old man from Khyber Pakhtunkhwa, and a 53-year-old man from Khyber Pakhtunkhwa. The male to female ratio was 1.2:1. The histological variations were sebaceous differentiation (n = 4), microcystic adnexal carcinoma (n = 4), trichilemmal carcinoma (n = 1), pilomatrix carcinoma (n = 1), and hidradenocarcinoma (n = 1). The mean age at presentation was 54 years (range 32 to 75). The primary subsite of involvement was the scalp in nine patients followed by eyelids in two patients. Surgery was the primary treatment modality in almost all patients; postoperative radiotherapy (PORT) was offered to eight patients. The median dose of radiation was 45 Gy to the primary site. Indications for radiotherapy included close margins (n = 2), positive margins (n = 1), high grade histology (n = 4), and multifocal disease (n = 1). On follow-up, two patients presented with local, one regional and two patients developed distant metastasis.ConclusionsAdnexal carcinomas are rare tumors with diverse histological patterns and a tendency for locoregional and distant metastasis. Surgery should be the mainstay of treatment reserving radiotherapy for adjuvant, palliative, and re-treatment scenarios.

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Section: Discussionmentioning

confidence: 99%

Retrospective study of rare cutaneous malignant adnexal tumors of the head and neck in a tertiary care cancer hospital: a case series

et al. 2017

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“…Other single institution, small case series have demonstrated similar local control rates with adjuvant RT ranging from 93-100%. 14, 24 In those two small series, varied radiation techniques were used and indications for radiation were primarily PNI and positive margin. No patients in these series had lymph node positive disease, whereas almost 50% of our patients did.…”

Section: Discussionmentioning

confidence: 99%

Surgery and Adjuvant Radiation for High-risk Skin Adnexal Carcinoma of the Head and Neck

Wang

Handorf

Wu³

et al. 2017

American Journal of Clinical Oncology

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OBJECTIVES Skin adnexal carcinoma (SAC) is a rare cutaneous malignancy that arises from sebaceous and sweat glands. These carcinomas are believed to behave more aggressively than cutaneous squamous cell carcinomas (SCC) with a propensity for local recurrence. The role of adjuvant radiotherapy in SAC is undefined. METHODS We retrospectively reviewed all cases of head and neck SAC treated with surgery and adjuvant radiation from 2000-2012 at a single institution. RESULTS Nine cases were identified. Median age was 67 (range 52-88). The histologies were: adnexal carcinoma (n=1), adnexal carcinoma with sebaceous differentiation (n=1), adnexal carcinoma with squamous differentiation (n=1), skin appendage carcinoma (n=1), sclerosing sweat duct carcinoma (n=1), mucinous carcinoma (n=1), ductal eccrine adenocarcinoma (n=1), porocarcinoma (n=1), and trichilemmal carcinoma (n=1). All tumors were reviewed by a dermatopathologist to confirm the SAC diagnosis. All patients had surgery. Indications for adjuvant radiation included involved lymph nodes (n=4), perineural invasion (n=2), nodal extracapsular extension (n=2), positive margin (n=1), high-grade histology (n=6), multi-focal disease (n=2), and/or recurrent disease (n=5). Radiation was delivered to the primary site alone (n=3), to the draining lymphatics alone (n=2), or to both (n=4). One patient received concurrent cisplatin. Median dose to the primary site was 60Gy and to the neck was 50Gy. Median follow-up was 4.0 years (0.6-11.4 years). Locoregional control was 100%. Five-year progression free survival was 89%. There was one acute grade 3 toxicity and no ≥grade 2 late toxicities were recorded. CONCLUSIONS Surgery and adjuvant radiation for high-risk SAC offers excellent locoregional control with acceptable toxicity.

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“…In addition to excision, radiotherapy was given to our patient. Although the use of adjuvant radiotherapy has been debatable, a recent study supported its efficacy [10].…”

Section: Discussionmentioning

confidence: 98%