Microcystic adnexal carcinoma. Report of a case with 30-year follow-up

Lupton, George P.

doi:10.1001/archderm.122.3.286

Cited by 55 publications

(46 citation statements)

References 6 publications

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“…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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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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“…In their study, at least 2 patients had positive margins after excision and surgical margins were unknown for 7 patients. Local recurrences many years after therapy have been reported, up to 30 years in one case [25]. Mohs micrographic surgery (MMS) has been recommended for MAC excision.…”

Section: Discussionmentioning

confidence: 99%

Microcystic Adnexal Carcinoma: Report of Seven Cases Including One with Lung Metastasis

et al. 2006

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Background: Microcystic adnexal carcinoma (MAC) is a rare cutaneous neoplasm, with a high rate of local recurrences. Objective: A series of MAC was analyzed and compared to previously published cases. Methods: Seven cases of MAC were identified in the register of the institution. Medical and pathological records were reviewed. Results: The primary MAC were located on the face in all patients, and 85% were initially misdiagnosed. The mean follow-up duration was 108 months. The recurrence rate was high: 4 patients developed recurrences. In 3 patients, the course of the disease was severe: one of them developed pathologically proven lung metastasis. Conclusion: The present study and review of the literature confirm the clinically aggressive evolution of MAC and its rare ability to give rise to metastasis. Long-term clinical follow-ups with imaging investigations are mandatory.

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“…This dual differentiation of this tumor was supported by immunoperoxidase staining for carcinoembryonic antigen [2|. Thereafter some authors have been reported cases of MAC [3][4][5] and similar neoplasms [6. 7].…”

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confidence: 81%

“…It is interesting that in our case the lesion exhibits very slow growth without metastasis or ulceration during 27 years. To our knowledge, this case is the longest present without ther apy, except for 1 patient who initially had a lesion of MAC excised 30 years prior to definitive treatment for recur rence at the original site [5], Goldstein et al [ 11 suggested the possibility that MAC exhibits both follicular and sweat gland differentiation. Apisarnthanarax ct al.…”

Section: Commentmentioning

confidence: 95%