Spiradenocylindrocarcinoma. Report of a Case With a Low-Grade Component of Spiradenocarcinoma and an Immunohistochemical Study

Apostolou, George; Apostolou, N.; Chatzipantelis, Paschalis; Biteli, Maria

doi:10.1097/dad.0b013e3181a4f75c

Cited by 10 publications

(16 citation statements)

References 9 publications

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“…Occasional reports have also commented on immunohistochemical expression of p53 and an increased Ki-67 proliferative index in areas of malignant transformation. 16,19,22 However, the tumors typically lack mutations in the TP53 gene, and our findings are in keeping with more recent and more comprehensive analyses, emphasizing that immunohistochemical staining for p53 in these tumors is heterogeneous and cannot be used reliably Figure 4 Low-grade spiradenocarcinoma. Cytologically, the nuclear-cytoplasmic ratio is increased, there is nuclear crowding and mitotic figures are readily identified (a).…”

Section: Modern Pathology (2015) 28 944-953supporting

confidence: 72%

“…1,2,14 However, only eighteen morphologically low-grade tumors are documented with limited clinical follow-up. 1,2,14,[16][17][18][19][20] On a large cohort of morphologically low-grade spiradenocarcinomas (basal cell adenocarcinomalike pattern, low-grade) with long-term follow-up we further characterized the clinical and histological features with particular emphasis on outcome to gain further insights into the behavior of this rare disease. We also studied the value of Ki-67 and p53 immunohistochemistry as a marker for malignant transformation, and investigated the genetic relationship of these tumors to adenoid cystic carcinoma and dermal cylindroma using immunohistochemical MYB expression as a surrogate marker for the recently described t(6;9) translocation, involving the MYB and NFIB genes.…”

Section: Discussionmentioning

confidence: 99%

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Morphologically low-grade spiradenocarcinoma: a clinicopathologic study of 19 cases with emphasis on outcome and MYB expression

et al. 2015

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Spiradenocarcinoma is a rare skin adnexal neoplasm with potential for aggressive behavior, classified histologically into low-and high-grade tumors. Morphologically, low-grade tumors are thought to behave more favorably. Limited information is available, however, with only 18 published cases. To study their clinical behavior, histological features, and the diagnostic value of immunohistochemistry, 19 morphologically low-grade spiradenocarcinomas were retrieved and compared with 21 spiradenomas and cylindromas. H&E-stained sections were reviewed, follow-up was obtained, and immunohistochemistry for Ki-67, p53 and, MYB was performed. The tumors were solitary, measuring 0.8-7 cm (median: 2.7 cm), with a predilection for the head and neck of elderly patients (median age: 72 years; range 53-92) without gender bias. Histologically, the tumors were multinodular and located in deep dermis and subcutis. A pre-existing spiradenoma was present in all cases. The malignant component was characterized by expansile growth with loss of the dual cell population, up to moderate cytological atypia and increased mitotic activity (median: 10/10 HPF; range 1-28). Additional findings included squamoid differentiation (n = 9), necrosis (n = 7), and ulceration (n = 5). P53 expression was variable and no significant differences were noted in the benign compared with the malignant parts of the tumors. In contrast, in the malignant components the Ki-67 proliferative index was slightly increased, and MYB expression was lost. Follow-up (median: 67 months; range: 13-132) available for 16 patients (84%) revealed a local recurrence rate of 19% but no metastases or disease-related mortality. In this large study with long-term followup, we demonstrate that spiradenocarcinomas with low-grade morphology pursue an indolent course, characterized by local recurrence only. Metastases and disease-related mortality appear to be exceptional. Lack of MYB expression may be useful as an additional aid in the diagnosis of these challenging tumors. Modern Pathology (2015) 28, 944-953; doi:10.1038/modpathol.2015 published online 10 April 2015 Eccrine spiradenoma and dermal cylindroma are closely related tumors. They share many morphologic features, and occasionally hybrid tumors with spiradenomatous and cylindromatous components are encountered. 1,2 Although typically observed sporadically as solitary neoplasms, they may rarely be multiple in the setting of the Brooke-Spiegler syndrome. 3,4 Similar to adenoid cystic carcinoma of the breast and salivary glands, the MYB-NFIB gene fusion product, due to a t(6;9)(q22 ∼ 23; p23 ∼ 24) translocation, has recently been demonstrated in a subset of dermal cylindromas, resulting in overexpression of the MYB protein. [5][6][7][8][9] MYB is a leucine zipper transcription factor and has an important role in cell proliferation, apoptosis and cell differentiation.

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Section: Modern Pathology (2015) 28 944-953supporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Morphologically low-grade spiradenocarcinoma: a clinicopathologic study of 19 cases with emphasis on outcome and MYB expression

et al. 2015

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“…Absence of necrosis and metaplastic changes should be considered in the diagnosis. 9 Low-grade cytologic features, lack of definitive changes between the benign and malignant components, and mild pleomorphism are all of the considerations in the diagnosis of a low-grade MES. 8 Although low-grade MES is thought to be associated with a better prognosis, case reports are too few in number to definitively compare them to high-grade MES.…”

Section: Discussionmentioning

confidence: 98%

Malignant Eccrine Spiradenoma of the Face

Nyame¹,

Mattos²,

Lian

et al. 2015

Journal of Craniofacial Surgery

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Malignant eccrine spiradenoma, or spiradenocarcinoma, is an exceedingly rare sweat-gland tumor, with only 102 reported cases. Low-grade carcinomas are especially rare with only a few cases reported. Because of the limited number of case reports, the biologic behavior of low-grade malignant eccrine spiradenoma is poorly understood and no evidence-based therapeutic approach is established. Here, the authors report a 29-year-old woman who presented with a history of left-sided facial lesions present since the age of 2 months. Histopathologic examination revealed multiple benign spiradenomas, several of which showed foci of low-grade malignant transformation evidenced by loss of the characteristic 2-cell population seen in the benign tumor component. Included are the clinical presentation, histopathologic description, and surgical decision making in an effort to guide recognition of this rare entity.

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“…Like its components, spiradenocylindroma is benign, may be solitary or multiple, and may show autosomal dominant familial inheritance. Malignant potential has also been observed, with clinical features of ulceration, rapid growth, pain, and change in color . Rarely, primary extracutaneous cases involving the rectum and kidney have been documented .…”

Section: Discussionmentioning

confidence: 99%

“…Malignant potential has also been observed, with clinical features of ulceration, rapid growth, pain, and change in color. [12][13][14] Rarely, primary extracutaneous cases involving the rectum and kidney have been documented. 15,16 Mortality from distant metastases of spiradenocylindrocarcinoma has also been reported.…”

mentioning

confidence: 99%