How to differentiate mucinous eccrine carcinoma from cutaneous metastasis of breast carcinoma?

Mona Mlika,Aida Ayadi-Kaddour,Faouzi El Mezni,Lamia Kassar,Emna Boudabbous

doi:10.7241/ourd.20124.77

Abstract

Eccrine skin tumors are rare and represent only 0,05% of all cutaneaous neoplasms. They represent a pitfall especially with cutaneous metastases of carcinoma which are more frequent. We report the case of a 60-year-old woman presented with a frontal scalp mass whose histologic and immunohistochemical features concluded initially to a cutaneous metastasis of breast carcinoma. The diagnosis was reviewed because of the absence of a breast lesion. The final diagnosis was primary sweet gland carcinoma. Histologic distinction between cutaneous metastatic breast carcinoma and primary cutaneous adnexal neoplasms can be very challenging or even impossible. This case illustrates this difficulty and puts emphasis on the necessity of keeping in mind the distinctive features between these two entities.

Highlights

25% of the patients with breast cancer develop cutaneous metastases
The major differential diagnosis of cutaneous metastatic breast cancer is represented by sweat gland carcinoma which accounts for about 0,05% of all cutaneous neoplasms [1,2]
We describe a new case of sweat gland carcinoma which presented a real diagnostic dilemma

Summary

Introduction

25% of the patients with breast cancer develop cutaneous metastases. The major differential diagnosis of cutaneous metastatic breast cancer is represented by sweat gland carcinoma which accounts for about 0,05% of all cutaneous neoplasms [1,2]. Cutaneous metastasis of breast carcinoma presents as multiple lesions in patients with a previous diagnosis of primary breast carcinoma, whereas, sweat gland carcinoma presents as a single cutaneous lesion in patients with unknown history of breast cancer. Cutaneous metastases of breast carcinoma can be difficult to distinguish from sweat gland carcinoma when the diagnosis is based mainly on histologic features and the clinical circumstances are unknown by the pathologist. Tumor cells didn’t express HER2-Neu antigen (Fig. 1d) These microscopic findings were suggestive of a cutaneous metastasis of an eventual mucinous breast carcinoma. A mammography and a chest MRI were performed targeting the primary breast lesion and showed no breast lesion Facing these radiologic findings, we concluded to a cutaneous mucinous eccrine carcinoma. The lesion was totally resected and the patient presented no complications after one year of follow up

Discussion

Findings

Conclusion