PRAME Immuno-Expression in Cutaneous Sebaceous Carcinoma: A Single Institutional Experience

Abstract

Background: In recent years, great research interest has been directed to the diagnostic, therapeutic and marker role of Preferentially expressed Antigen in Melanoma (PRAME) in the setting of various human neoplasms. Although it has been extensively studied mainly in the differential diagnosis setting of melanocytic pigmented lesions, still very few papers have analyzed the usefulness or otherwise of PRAME in the context of other non-melanoma skin cancers (NMSC). (2) Methods: In this paper, we report the data of our experience of 21 cases of sebaceous carcinoma (SC) classified in the three WHO grade and collected in the period between January 2005 and 31 October 2022, on which immunostaining for PRAME was performed; Non-parametric Mann–Whitney test for non-normally distributed values was performed. A comparison was made of the means between the three study groups (grade I, II and III). A value of p ≤ 0.05 was set as statistically significant (3) Results: Only seven cases (33.3%) were positive with an immunoscore of 2+/3+ for intensity and 1+/2+ for percentage cells positivity, while 14 cases (66.6%) were totally or nearly totally negative for PRAME with a few of sebaceous-like cells positive with an immunoscore of 1+. Eight cases of SC grade I were immunostaining for PRAME, a level of the cytoplasm of foci of sebaceous differentiation with a significant statical value (p < 0.0001) with respect to ten cases of SC grade II; furthermore, the eight cases of grade I were positive for PRAME in the same areas respect the 3 cases of SC grade III (p = 0.0303). There were no statistical significance between the 10 cases of grade II and 3 cases of grade III (p = 0.2028); (4) Conclusions: PRAME not seems to add particular information in the case of histopathological diagnostics of SC where other markers, including adipophylline, can be quite indicative. It seems, on the other hand, that PRAME can be useful in the subclassification setting of sebaceous carcinoma in grades I–II–III according to the directives of the latest WHO 2018, highlighting the foci of mature sebaceous differentiation most present in grades 1–2 and almost completely absent in grade 3 of the SC.

Androgen Receptor Immunohistochemistry is Superior to PRAME for the Differentiation of Sebaceous Carcinoma From Primary Cutaneous Basaloid Mimics

“…12,13 In contrast, other work has described only rare cytoplasmic PRAME positivity in SC, in the sebocytic and basaloid components. 34,35 These latter findings are in line with our own, because we report that 56% of SC were negative for PRAME, and those positive cases show only weak and focal cytoplasmic expression. AR, however, showed strong and extensive expression in 66% of SC (Figs.…”

PReferentially Expressed Antigen in MElanoma (PRAME): preliminary communication on a translational tool able to early detect Oral Malignant Melanoma (OMM)

“…In the recent years, several studies have found the reliability of the marker called PReferentially expressed Antigen in MElanoma (PRAME), as a strategic advisor about the potential malignancy of a dermatological pigmented lesion. More in details, after the first paper by Lezcano et al 10 , which demonstrated the usefulness and reliability of PRAME in a cohort of pigmented melanocytic lesions, several other authors 15 - 22 have highlighted the potential (and limits, of course) of this immunostaining technique.…”

Periocular Sebaceous Carcinoma: A Case Audit from the National Specialist Ophthalmic Pathology Service in Liverpool from 2009 to 2022 to Assess the Diagnostic Utility of PRAME Expression

“…SC is a malignant sebaceous neoplasm that can occur at any site but most commonly in the head and neck region, particularly at the periocular location [3,4,6,14]. Extraocular SC is encountered in the skin of the head and neck, followed by the trunk, genital regions, and extremities [3,4,6,14].…”