Apocrine adenocarcinoma of the eyelid with aggressive biological behavior: Report of a case

Abstract

A case of apocrine adenocarcinoma of the eyelid that showed unusually aggressive biological behavior is reported. The patient was a 57-year-old man who complained of discomfort and excessive lacrimation of the left eye. A subcutaneous tumor measuring 2.5 cm was found at the medial canthus of the upper eyelid, and a plica-like subconjunctival spread was noted in the lacrimal caruncle. Invasion into the extraocular muscles and metastasis to the cervical lymph nodes and bone were already present at the time of initial presentation. Histopathologically, the tumor showed features of poorly differentiated adenocarcinoma, and polygonal tumor cells had large, hyperchromatic nuclei with prominent nucleoli and abundant eosinophilic cytoplasm. The formation of ductal structures was found occasionally. The differentiation of the tumor cells towards the apocrine gland was corroborated by immunohistochemistry using monoclonal antibodies GCDFP-15 and B72.3. The histogenesis and pathological differential diagnosis are discussed briefly, and the tumor was considered to have originated in the Moll's gland in the eyelid. This case emphasizes that apocrine adenocarcinomas of the ocular region have the potential for aggressive biological behavior, including distant metastasis.

Epidemiological and histopathological analysis of 40 apocrine sweat gland carcinomas in dogs: a retrospective study

“…Mutations of several genes, particularly gene p53, were previously described in several malignant tumours of the sweat gland in humans, with indication of ultraviolet radiation as one of inducting factors (3). Low incidence of the cancer precludes not only clinical trials, but also possibilities of extensive research on this tumour in human medicine, as only isolated cases of human apocrine sweat gland cancer have been reported in the literature worldwide (1,6,10,13,14). Moreover, in humans, apocrine sweat gland carcinomas are classified as a subtype of sweat gland tumours, which account for around 0.01% of primary skin tumours (1).…”

“…In fact, due to the rarity of the disease, histological diagnostic criteria of ASGCs and their classification in humans remain unclear (5,17). This in return causes difficulties in establishing proper treatment, which is an important issue, as the development of this cancer is associated with metastases leading to negative prognosis (6,14). This type of cancer, although rare, appears to be diagnosed more frequently in dogs than in humans (10), therefore, canine apocrine sweat gland carcinoma might serve as an animal model for research on aetiopathology of this cancer.…”

Metastatic apocrine sweat gland adenocarcinoma in a terrier dog

“…The pathological distinction between benign and malignant neoplasms is not easy in apocrine tumors [20] . In the present case, despite the relatively small size of the primary tumor, the patient already had metastasis to the local and distant lymph nodes at the time of tumor recurrence.…”

Primary cutaneous apocrine carcinoma arising within a congenital nevus: Keratins and filaggrin expression suggesting differentiation into the secretory cells of apocrine glands

“…Approximately 40 cases of PCAC have been reported (1). The majority of PCACs are relatively indolent, but some are rapidly progressive (13). The prognosis of PCAC is generally favorable and depends on the degree of tumor differentiation.…”