Independent primary cutaneous and mammary apocrine carcinomas with neuroendocrine differentiation: Report of a case and literature review.

Autor: DeCoste RC; Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada., Carter MD; Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada., Barnes PJ; Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada., Andea AA; Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.; Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA., Wang M; Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA., Rayson D; Division of Medical Oncology and Department of Medicine, Nova Scotia Health Authority (Central Zone) and Dalhousie University, Halifax, Nova Scotia, Canada., Walsh NM; Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.; Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Jazyk: angličtina
Zdroj: Journal of cutaneous pathology [J Cutan Pathol] 2021 Nov; Vol. 48 (11), pp. 1397-1403. Date of Electronic Publication: 2021 Jul 02.
DOI: 10.1111/cup.14085
Abstrakt: Cutaneous apocrine carcinomas share common features with their counterparts in the breast; hence, metastatic mammary carcinoma must be excluded before such lesions can be designated primary cutaneous neoplasms. Primary tumors from either source rarely exhibit neuroendocrine differentiation. We report a case of a 72-year-old female with a painless 1.2-cm scalp nodule. An incisional biopsy revealed dermal involvement by an invasive apocrine carcinoma juxtaposed to a benign apocrine cystic lesion. Immunohistochemically, the carcinoma expressed neuroendocrine proteins including synaptophysin, chromogranin, and CD56. A primary cutaneous apocrine carcinoma with neuroendocrine differentiation was favored, but additional investigations to exclude breast origin were recommended. These revealed a 1.1-cm nodule in the right breast, which proved to be an invasive ductal carcinoma, morphologically and immunophenotypically similar to the scalp lesion. This confounded the case, yet factors militating against metastatic breast carcinoma to skin included (a) the small size of the mammary tumor, (b) absence of other metastatic disease, and (c) juxtaposition of the scalp carcinoma to a putative benign precursor. Molecular studies were undertaken to resolve the diagnostic quandary. Single nucleotide polymorphism microarray analysis revealed distinct patterns of chromosomal copy number alterations in the two tumors, supporting the concept of synchronous and unusual primary neoplasms.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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