Apocrine gland adenoma and adenocarcinoma of the axilla

Abstract

Apocrine tumors from the axilla of 12 patients were studied clinically and pathologically. Based on histologic features, two tumors were classified as adenomas and ten as adenocarcinomas. All of the neoplasms were characterized by a glandular arrangement of large cells with abundant eosinophillic cytoplasm and evidence of decapitation secretion. The cytoplasm of the tumor cells contained PAS-positive, diastase-resistant granules. Intracytoplasmic particles of iron were demonstrable in three of ten tumors. Follow-up was available for all 12 patients. The two patients with apocrine adenoma are alive and well. Two patients with adenocarcinoma died of unrelated causes shortly after diagnosis. Of the remaining eight patients with adenocarcinoma, three have died of disease, and one is living with skeletal metastasis. A correlation appears to exist between tumor differentiation and prognosis.

Two Cases of Cutaneous Apocrine Ductal Carcinoma of the Axilla

“…The most common site in which CADC developed was the axilla. The 10 CADC cases described by Warkel and Helwig [2]involved the axilla, as well as 18 other cases from the literature [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. Five cases developed on the scalp, 4 [16]were associated with sebaceous nevus and 1 [5]with cylindroma.…”

“…Moreover it shows various forms, such as papillary, complex glandular, tubular, solid cellular sheets and cord-like arrangements [2, 19, 20], according to the degree of differentiation. Tumor cells show mitotic figures and the nuclei of atypical cells are large and vesicular with prominent nucleoli.…”

“…The remaining 10 tumors reported by Warkel and Helwig [2]were not included in table 2, because they were not described with detailed individual clinical features. Some of the 43 tumors had insufficient findings to confirm apocrine differentiation [8, 13, 18, 22].…”

“…Only 4 of the 32 patients died of the disease (follow-up 0.4–7.7 years). Therefore the prognosis of CADC is generally favorable and depends on the degree of tumor differentiation [2]. …”

“…They occur most frequently in the axilla [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]but are occasionally found in other areas, such as in the anogenital area [15], nipple [1], scalp [5, 16], face [17], trunk [1, 18], acral sites [1, 2, 4, 5, 6, 7, 8, 10, 18, 19, 20], wrist [21], fingertip [22]and lip [23]. Their histological and clinical features are poorly defined because of their rarity.…”