Primary Mucinous Carcinoma of the Skin

Abstract

Primary mucinous carcinomas of the skin are very rare. To date, 120 cases have been described in the literature. This tumor is a histologic subtype of sweat gland carcinoma. Because of the histopathologic appearance, primary mucinous carcinoma of the skin can be mistaken for metastasis from extracutaneous sites. We report on the cases of two elderly women with mucinous carcinomas arising in the scalp. Immunohistochemical staining of both tumors was positive for low-molecular-weight cytokeratin and epithelial membrane antigen. Carcinoembryonic antigen was positive in Case 2. Neuroendocrine features represented by neuron-enolase-specific positivity were also observed in both cases, and Grimelius and chromogranin A positivity were observed in Case 2. In both cases, there was strong positivity for estrogen receptor and progesterone receptor. Image analysis cytometry showed a diploid DNA content with a low rate of proliferative cells and negativity for p53 and c-erbB-2 proteins in agreement with the low aggressiveness of these neoplasms.

Primary Cutaneous Mucinous Carcinoma Initially Diagnosed as Metastatic Adenocarcinoma

“…Some of them show neuroendocrine features (Wako et al 2003). The present case lacked the immunoreactivity for CEA and GCDFP-15, but this does not rule out the possibility of mucinous carcinoma of the skin because some cases of this neoplasm showed no reactivity for CEA (Bellezza et al 2000).…”

“…In general, cutaneous mucinous carcinoma shows carcinoma cells arranged in cords, small nests and small tubules embedded in mucinous materials which are separated by fibrous septae (Lennox et al 1952;Mendoza and Helwig 1971;Lever and Lever 1990;Bellezza et al 2000;Breier et al 2000;Ohnishi et al 2002;Wako et al 2003). The present case, in contrast, showed that relatively large tumor nests with adenocystic appearances with pseudolumens were embedded in mucinous stroma.…”

“…Immunohistochemically, primary cutaneous mucinous carcinoma has a tendency to show immunoreactivities for CEA, epithelial membrane antigen and broad spectrum cytokeratins (Bellezza et al 2000;Wako et al 2003). Some of them show neuroendocrine features (Wako et al 2003).…”

“…It is occasionally misdiagnosed as metastatic mucinous carcinoma (Lennox et al 1952;Mendoza and Helwig 1971;Lever and Lever 1990;Bellezza et al 2000;Breier et al 2000;Ohnishi et al 2002;Wako et al 2003). It is low-grade malignant, and distant and lymph node metastasis is uncommon though local recurrence is relatively frequent (Lennox et al 1952;Mendoza and Helwig 1971;Lever and Lever 1990;Bellezza et al 2000;Breier et al tion was recognized around the lumens. Neither keratinization nor intercellular bridges were recognized.…”

Primary cutaneous mucinous carcinoma of the penis

“…4 Recommended treatment includes standard to wide local excision. 2,3,9,12 Other approaches include Mohs surgery, 13 the addition of regional node dissection, 4 and the use of adjuvant hormone therapy with antiestrogenic agents, such as tamoxifen, to reduce the risk of recurrence. 10 Recurrent PCMS appears to be resistant to both chemotherapy and radiation.…”