Apocrine Gland Carcinoma Research Articles

PRIMARY CUTANEOUS APOCRINE CARCINOMA IN AN ELDERLY MAN: A RARE ENTITY, ABOUT A CASE

Primary cutaneous gland apocrine carcinoma, a subtype of sweat gland carcinoma, is an extremely rare malignancy and only a few cases have been reported in the literature. It involves the axillary region but can occur elsewhere on the skin. It is indolent and slow growing. Treatment remains surgical with wide local excision and healthy margins, with or without lymph node dissection. We report a case of a 79-year-old man who came to our hospital with a cauliflower-like mass in the right axilla measuring 1.5 × 1 cm. Histological evaluation showed features of apocrine gland carcinoma arising in an area of high apocrine gland density. The objective of this work is to highlight the diagnostic difficulty that this entity can present and the importance of anatomopathological examination to make the diagnosis and eliminate differential diagnoses.

Cryotherapy to treat benign skin tumours in conscious dogs.

Cryotherapy can be used to treat benign skin lesions without general anaesthesia. This technique has only been described in anaesthetized dogs. To describe the feasibility, safety and efficacy of cryotherapy to treat benign skin tumours in conscious dogs. Twenty-five client-owned dogs with 52 skin tumours diagnosed as benign sebaceous neoplasia (46) or follicular cysts (six). Cryotherapy was performed in conscious dogs using a liquid nitrogen spray technique with a handheld spray-release system. If needed, cryotherapy was repeated every three to four weeks until complete cure was achieved or for a maximum of eight treatments. Effectiveness and adverse effects were recorded. Resolution was obtained for 29 of 52 lesions (57%) with a median number of one to two cryotherapy sessions. Eighteen of 52 (35%) lesions shrank to <0.1cm. In one case, the tumour enlarged after cryotherapy, and histopathological examination of the excisional biopsy revealed an apocrine gland carcinoma. Pain and discomfort during the treatment were the most common adverse effects (33%). In the present study, cryotherapy was possible in conscious dogs and proved to be effective to cure or reduce the size of benign sebaceous tumours and follicular cysts. The procedure is safe but the degree of pain during the treatment needs to be further investigated. Worsening of the lesion after cryotherapy suggests the need for surgical removal and histopathological examination.

How to Treat Sweat Gland Adenocarcinoma of the Eyelid: Case Report

Background: It is thought that apocrine gland carcinoma in the eyelid is rare and its prognosis is very poor. To achieve a curative treatment, we must remove the tumour with surrounding normal tissue, such as orbital contents or the skin of the face, in which case the loss of physiologic lacrimal function and facial cosmesis are serious concerns. Methods: A case presentation, treatment, and review of the literature and discussed. Results: Patient was a 54-year-old male. The tumour at the right inferior eyelid extended to the upper eyelid via the medial can thus, infraorbital fat tissue and medial rectus muscle. We performed a curative operation. The tumor was removed completely, along with the medial side of the eyelids, orbital contents and the right maxillary bone. Conclusions: We performed the treatment for adenocarcinoma of the eyelid. As a result, we could obtain patient’s and his families’ satisfaction.

Primary cutaneous apocrine gland carcinoma from areolar tissue in a male patient with gynecomastia: a case report

Primary cutaneous apocrine gland carcinoma, which is a type of sweat gland carcinoma, is an extremely rare type of cancer. Clinical courses of this type of cancer usually progress slowly but can, occasionally, be associated with rapid progression. This case report describes a 53-year-old Korean man with primary cutaneous apocrine gland carcinoma that arose from an apocrine gland in the areola tissue. The patient visited our hospital because of a large, painful chest wall mass beneath the right nipple. The mass had been present for more than eight years but had grown rapidly over the past few months. The patient was initially diagnosed with a benign cystic mass, and we performed a wide excision with a clear margin and without lymph node dissection. The mass was a well-encapsulated cystic lesion that contained old blood material, and there was no invasion into the surrounding tissue. The final pathology showed that the mass was a primary cutaneous apocrine gland carcinoma that arose from the areola apocrine sweat gland, not from the breast parenchymal tissue. Herein, we report an extremely rare chest wall mass unfamiliar to thoracic surgeons.

Metastatic anal sac carcinoma with hypercalcaemia and associated hypertrophic osteopathy in a dog

A seven-year-old male neutered Irish setter was treated for a metastatic anal sac adenocarcinoma (ASAC) and hypercalcaemia by complete surgical excision of the primary tumour and partial excision of the sublumbar lymph nodes. Further enlargement of the sublumbar lymph nodes was linked to recurrent hypercalcaemia 3 months after surgical treatment. Medical treatment with Toceranib and Clodronate showed modest results in the treatment of the tumour and the hypercalcaemia. Radiotherapy of the sublumbar lymph nodes and later concurrent carboplatin chemotherapy resulted in partial tumour remission with marked reduction in size of the lymph nodes and normalization of the calcaemia. Unfortunately, concurrently with subsequent relapse of the hypercalaemia, the dog developed hypertrophic osteopathy (HO) and lumbar spinal metastasis and the dog was euthanized. To the authors’ knowledge, this is the second case of metastatic apocrine gland carcinoma of the anal sac associated with HO and the first case that describe the development of HO late in the stage of the disease.

Analysis of non-squamous vulvar cancer cases: A 21-year experience in a single center.

Objective:To evaluate the patients with non-squamous cell type of vulvar cancer who were treated in our clinic within 21 years.Materials and Methods:We assessed the data of 14 patients who were treated for non-squamous cancer of the vulva between January 1992 and August 2013. The age of patients, histopathological diagnosis of the tumor, tumor size, tumor location, medical or surgical treatment, response to the treatment, recurrence, and survival rates were analyzed.Results:The mean age of the patients was 53 years. The main complaint was vulvar pruritus (71%). Mean tumor size was 2.4 cm (range: 0.5-6 cm). In 65% of cases, the tumor was localized in the labia majora. The histopathologic diagnosis of the patients was as follows: malignant melanoma in 5 patients, basal cell carcinoma in 5 patients, mucinous type adenocarcinoma in 2 patients, apocrine gland carcinoma in one patients, and malign peripheral nerve sheath tumor in 1 patient. For 11 patients, surgery was the primary treatment. Radical vulvectomy and bilateral inguinofemoral lymphadenectomy were performed in 8 patients. Local excision alone without lymphadenectomy was performed in other 3 patients. Five of eight patients (62.5%), who undergone radical surgery, had lymph node metastases. Of these 5 patients, two had bilateral lymph node metastasis. Mean follow-up time was 49.2 months (range 12 to 72 months). Eight (57.1%) patients had suffered first recurrence. In those patients, the mean time to recurrence was 19.5 months (range, 6-48 months).Conclusion:Non-squamous cell vulvar cancer is a rare disease and comprises a heterogeneous group of tumors. Malignant melanoma is the most aggressive one. Multicenter prospective studies are necessary in order to standardize the treatment of these rare tumors.

A Patient with Apocrine Gland Carcinoma Who Received Extended Resection after Radiation Therapy

A Patient with Apocrine Gland Carcinoma Who Received Extended Resection after Radiation Therapy

Treatment and outcome of four cats with apocrine gland carcinoma of the anal sac and review of the literature

Anal sac adenocarcinoma is uncommon in cats. We report the outcome of multi-modality therapy in two cats (surgery, definitive radiotherapy and systemic chemotherapy) and surgery alone in two cats. All received surgical excision of the primary tumour followed by radiotherapy and carboplatin chemotherapy in two cases. Both cats that underwent multimodal therapy developed distant metastatic disease and one developed recurrence of the primary tumour. One cat that underwent surgery alone with incomplete margins also developed rapid recurrence. Overall survival times were 89, 161 and 169 days. One cat that had complete surgical excision is still alive without recurrence 425 days postoperatively. Whilst the role of radiation in the local control of this disease is yet to be defined, clearly a more effective systemic therapy is required before such aggressive local treatment can be routinely recommended.

β-Catenin in Canine Skin: Immunohistochemical Pattern of Expression in Normal Skin and Cutaneous Epithelial Tumours

In normal adult skin, β-catenin is a structural component of the intercellular junction and the Wnt/β-catenin pathway plays a key role in the regulation of cutaneous homeostasis, particularly in the maintenance of hair follicle stem cells. No data are available on the expression pattern of β-catenin in normal canine skin and in canine cutaneous epidermal and follicular tumours. The present study used immunohistochemistry to determine β-catenin expression in four samples of normal canine skin and 62 cutaneous epithelial tumours (14 epidermal, 30 follicular and 18 glandular). β-catenin expression was localized to the nucleus of matrical and dermal papilla cells in anagen hair follicles and was also found in scattered cells of the outer root sheath, suggesting that these follicular epithelial cells may have a high proliferative potential. Nuclear labelling, considered a hallmark of activation of the Wnt/β-catenin signalling pathway, was observed in canine follicular tumours with matrical differentiation (100% of cases of trichoepithelioma and pilomatricoma), suggesting that a possible mutation of the canine CTNBB1 gene may underlie these tumours. In contrast, malignant tumours (squamous cell carcinoma, basal cell carcinoma, sebaceous and apocrine gland carcinoma and epithelioma) were characterized by reduction/loss of β-catenin membrane labelling compared with normal cutaneous epithelial cells and benign tumours, suggesting that reduction/loss of β-catenin expression is important in the acquisition of the malignant phenotype and may have a role in the infiltration and metastasis of these tumours.

Apocrine gland carcinoma of the mammary skin concomitant with pagetoid phenomenon

We reported a 52-year-old woman with an apocrine gland carcinoma of the mammary skin concomitant with pagetoid phenomenon. She had a 23-year history of a small nodular lesion on the lower left part of her right breast with a 1-year history of the pigmented plaque spreading peripherally around the nodule. Our diagnosis revealed that the nodule was an apocrine gland carcinoma and the intraepidermal neoplastic cells with pagetoid spread in the pigmented plaque were derived from the apocrine gland carcinoma. No Paget's cells were detected in the right nipple, and no tumor cells were observed in the sentinel lymph node and underlying mammary gland tissue. We also investigated the immunohistochemical changes in this case. They showed that both intraepidermal neoplastic cells with pagetoid spread and tumor cells of the apocrine gland carcinoma were positive with cytokeratin-7 and human epidermal growth factor receptor-2 (HER-2)/neu overexpression. The results of the present study conclude that the intraepithelial spread of tumor cells in the mammary skin distant from the nipple occurred as a pagetoid phenomenon, and that HER-2 may have a key role in pagetoid phenomenon of an underlying apocrine gland carcinoma, as well as in mammary Paget's disease.

A rare cutaneous tumor of the axilla: Apocrine adenocarcinoma

Sweat gland neoplasms are rare with approximately 200 cases of eccrine sweat gland and less than 50 cases of apocrine gland carcinoma being reported in the worldwide literature. More than half of the reported cases with apocrine adenocarcinoma had lymph node metastases at the time of diagnosis. We report a case of a 56-year-old man, presented with a left axillary slow-growing seven year old painless nodule. Histopathological examination revealed an invasive apocrine adenocarcinoma with lymph node metastases. The patient successfully treated with total excision and radiotherapy. Apocrine adenocarcinoma is a rare malignancy with high metastatic potential that occurs mostly in the axilla. Physicians should be aware of this entity while differentiating cutaneous tumor located on the axillary region.

A case of T1N0M0 vulvar apocrine gland carcinoma with a positive outcome

Background Apocrine carcinoma of the vulva is extremely rare; only two cases have been reported worldwide. Here we report a case of apocrine carcinoma of the vulva. Case A 58-year-old woman complaining of a small, asymptomatic genital tumor visited the gynecology clinic of Chiba Social Insurance Hospital. The biopsy specimen suggested that it was an adenocarcinoma derived from the apocrine gland. The diagnosis was confirmed by periodic acid–Schiff staining and immunohistochemical staining for gross cystic disease fluid protein 15. She underwent simple vulvectomy with hemilateral groin dissection. She has been followed as an outpatient for the past 7 years with no signs of recurrence or metastasis. Conclusion Despite the positive outcome of this case, small, asymptomatic genital lesions should be regarded with caution.

Canine anal sac adenocarcinomas: clinical presentation and response to therapy.

A retrospective study of 43 dogs with anal sac adenocarcinoma (ASAC) was performed to characterize the clinical presentation and response to treatment. Clinical signs at presentation varied considerably, with signs related either to sublumbar nodal metastasis (tenesmus or constipation) or hypercalcemia (polyuria-polydipsia and anorexia) being the most frequent findings. At the time of presentation, 23 (53%) dogs had hypercalcemia and 34 (79%) had metastases, with the regional lymph nodes (31 dogs, 72%) being the most common site of metastasis. A variety of chemotherapeutic agents were administered, with partial remission (PR) recorded in 4 of 13 (31%) dogs treated with cisplatin and in 1 of 3 (33%) dogs treated with carboplatin. The median survival for all dogs was 6 months (range, 2 days-41 months). There was no statistical association between the presence of hypercalcemia and survival, although the power of the study to detect an increase in survival of 3 months was low (.33). We conclude that platinum chemotherapy has antitumor activity in canine apocrine gland carcinoma and that further study of these agents is warranted.

Canine Anal Sac Adenocarcinomas: Clinical Presentation and Response to Therapy

A retrospective study of 43 dogs with anal sac adenocarcinoma (ASAC) was performed to characterize the clinical presentation and response to treatment. Clinical signs at presentation varied considerably, with signs related either to sublumbar nodal metastasis (tenesmus or constipation) or hypercalcemia (polyuria‐polydipsia and anorexia) being the most frequent findings. At the time of presentation, 23 (53%) dogs had hypercalcemia and 34 (79%) had metastases, with the regional lymph nodes (31 dogs, 72%) being the most common site of metastasis. A variety of chemotherapeutic agents were administered, with partial remission (PR) recorded in 4 of 13 (31%) dogs treated with cisplatin and in 1 of 3 (33%) dogs treated with carboplatin. The median survival for all dogs was 6 months (range, 2 days‐41 months). There was no statistical association between the presence of hypercalcemia and survival, although the power of the study to detect an increase in survival of 3 months was low (.33). We conclude that platinum chemotherapy has antitumor activity in canine apocrine gland carcinoma and that further study of these agents is warranted.

Clinical Management of a Case of Recurrent Apocrine Gland Carcinoma of the Scalp: Efficacy of a Chemotherapy Schedule with Methotrexate and Bleomycin

Apocrine carcinoma of the skin is a rare tumor. Wide surgical excision with complete removal of the neoplasm is the standard therapy and this appears to offer the best chance of cure. Radiotherapy may be used in case of local relapse or regional lymph node involvement. Systemic chemotherapy has not proved to be effective in the treatment of this tumor. We report on a 46-year-old woman with a recurrent apocrine carcinoma of the scalp that had previously been treated with surgery, radiotherapy and chemotherapy (Al-Saraff schedule). The patient was responsive to a second-line systemic chemotherapy regimen consisting of a weekly combination of methotrexate and bleomycin, and achieved long-term progression-free survival.

Apocrine Carcinoma with Signet Ring Cells and Histiocytoid FeaturesA Potentially Confusing Axillary Tumor

A case of carcinoma of the axillary apocrine gland in a 42-year-old man is reported. The cytomorphic features of this tumor on fine-needle aspiration closely resemble invasive lobular carcinoma of the breast. Both in situ, and invasive apocrine gland carcinoma were present within the excision specimen, and metastatic tumor was found in the axillary lymph nodes. On histologic, immunohistochemical and ultrastructural examination, the tumor was similar to invasive lobular carcinoma of the breast. The tumor cells analyzed by cytometry displayed a diploid pattern. Serial sections of the whole resected specimen failed to reveal breast parenchyma. To the best of our knowledge, this is the first case presented in axilla of an unusual variant of carcinoma of the skin, very similar or identical to six other cases located on the eyelids. The descriptive term "apocrine carcinoma with signet ring cells and histiocytoid features" is proposed in order to emphasize that these tumors are easily confused with benign conditions, mammary cancer and other metastatic carcinomas.

Apocrine Gland Carcinoma

Apocrine Gland Carcinoma

骨転移を示した犬の皮膚原発アポクリン腺癌の1例

骨転移を示した犬の皮膚原発アポクリン腺癌の1例

Carcinoma of the anal sac glands in ranch mink.

During a 14-year period, carcinoma of the anal sac apocrine glands was found in 52 pastel and 8 sapphire mink (Mustela vison) kept for studies on slow viral diseases. The pastel mink varied in age from 72 to 135 months (mean age 108 months), the sapphire mink from 63 to 100 months (mean age 81 months). All but one pastel mink were females. The primary tumor varied in size from masses that caused bulges in the perineum to those that were found only after microscopic examination of the anal sac glands. Although the primary tumor grew mainly by expansion with little local infiltration, 41 of the 60 tumors had metastasized to the regional lymph nodes and sometimes also to more distant sites. The striking propensity of the carcinoma to metastasize while still small, even microscopic, often resulted in massive secondary growths, notably in the iliac lymph nodes. Hypercalcemia did not accompany the carcinoma. Its varied microscopic appearance included solid, glandular, squamous cell, and spindle or round cell components. Combinations of them formed mixed or complex histologic patterns, no doubt largely attributable to neoplastic proliferation of myoepithelial cells and squamous metaplasia of the apocrine gland epithelium. Although its cause remains obscure, the carcinoma appeared to arise from small foci of hyperplastic apocrine glands, sometimes in relation to both anal sacs. The tumor is a common and distinctive expression of neoplasia in older ranch mink.

Extramammary Paget's disease of the external ear canal in association with ceruminous gland carcinoma.A case report

A case of extramammary Paget's disease of the external ear canal in association with ceruminous gland carcinoma is presented. Extramammary Paget's disease is not uncommonly seen in regions where apocrine glands are prevalent, with or without underlying apocrine gland carcinoma. This is the first case, to our knowledge, of this association in the external ear canal.