Apocrine carcinoma of the scalp with neck lymph node metastasis: A case report and review of the literature

Abstract

Primary cutaneous apocrine carcinoma (PCAC) is an extremely rare malignancy. Distinguishing apocrine carcinoma from breast carcinoma metastasis is difficult. Only a few cases reported as PCAC of the scalp and primarily treated by wide local excision. The usual presentation is a skin lesion that rapidly progresses over the duration of a few weeks to few months. We reported a 56-year-old man with a right scalp ulcerative lesion diagnosed as a CAC. The patient underwent wide local excision. 1.5 years later, the patient developed neck lymph node metastasis that treated with neck dissection and adjuvant radiotherapy. No chemotherapy was given due to limited literature, suggesting substantial benefits of adjuvant chemotherapy for such cases. Review literature was performed to assess the clinical presentation, treatment, and prognosis of such malignancies. PCAC of the scalp is a challenging malignancy in the diagnosis and management.

¿Carcinoma de mama o carcinoma de glándula sudorípara? Presentación de dos casos y análisis de la literatura

“…A diferencia de otras localizaciones, los tumores en cabeza y cuello se tratan más frecuentemente con disecciones ganglionares cervicales con o sin radioterapia cuando se ha determinado clínicamente o mediante ganglio centinela el compromiso ganglionar. Cabe resaltar que en esta localización hay una gran probabilidad de enfermedad metastásica, asociada principalmente a un mayor volumen tumoral en el momento del diagnóstico 16 . En un análisis retrospectivo sobre tumores de anexos cutáneos localizados en cabeza y cuello, se encontró que la calidad de la resección se relacionaba directamente con el pronóstico, en tanto que otras variables, como la edad avanzada, el alto grado o el gran volumen tumoral, así como la presencia de compromiso ganglionar, se comportaban como factores de pronóstico adverso.…”

“…En el análisis de la literatura (búsqueda en Pubmed y Embase de artículos publicados e indexados entre 1975 y 2020, disponibles en texto completo en inglés, español, francés y alemán; no se consideraron comunicaciones orales o resúmenes; las palabras clave incluyeron los términos "glándulas sudoríparas" "carcinoma" "neoplasias cutáneas" "glándulas apocrinas"), se encontraron 102 casos de carcinoma apocrino primario de glándulas sudoríparas reportados entre 1978 y 2020 que, junto con los dos informados aquí, se resumen en el cuadro 2 1 , 3 , 15 , 16 , 18 , 24 .…”

Primary cutaneous apocrine carcinoma of the scalp

“…In total, 36 cases had detailed reports that were gathered and condensed in Table 1. [1,3,4,[7][8][9][10][11][12]14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Of the 36 cases obtained, 16 were in female patients and 20 were in male patients. The average age at the time of diagnosis was 60.8 years and it ranged from 20 to 85 years.…”

“…Of the 36 cases reported, 20 developed characteristics and symptoms induced by the tumor. The following features were described in the aforementioned articles: firmness (5); painlessness (5); red color (5); ulceration (4); plaque (4); hairlessness (4); bleeding (3); erythema (3); multiple nodules (2); granular appearance (2); polypoid appearance (1); keloid-like appearance (1); induration (1); raised appearance (1); papule (1); exophytic appearance (1); exudation (1); pus discharge (1); malodor (1); crust (1); pink color (1); pearliness (1); palpability (1); roughness (1); and mild itching (1).…”

“…Apocrine carcinoma is a rare malignant sweat gland tumor that has only been reported in approximately 200 cases. [1] Apocrine carcinoma primarily develops between the ages of 60 and 70 years among Caucasians, and its cause remains unknown. [2] It varies from red to purple.…”