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

Morabito, Alessandro; Bevilacqua, P.; Vitale, S.; Fanelli, Massimo; Gattuso, Domenico; Gasparini, Giampietro

doi:10.1177/030089160008600608

Cited by 32 publications

(39 citation statements)

References 12 publications

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“…Surgical intervention alone, following node positive disease provided mixed responses from 2 months to 1 year [3,5]. On a separate account, in addition to excision of the primary and lymphadectomy, adjuvant chemotherapy (5-fluorouracil and cisplatin) and radiotherapy were administered and provided the patient with 9 months of disease free status [2].…”

Section: Literature Review Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…PCAC has a diverse presentation, occurring as both uniand multi-nodular growths with varying colour [2]. Often these neoplasms are indurated, painless masses and can be associated with benign lesions [2], including a nevus sebaceous, most commonly seen with scalp lesions [4][5][6]. Development of these lesions typically occurs within a year before diagnosis [7]; however several cases have reported longer durations with a period of rapid growth [4,5,8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 200 total cases are reported in the literature. PCAC occurs in areas with large numbers of apocrine glands [2]. The scalp is among one of the rarest sites of occurrence, while the axilla appears most commonly [3].…”

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confidence: 99%

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Treatment of primary cutaneous apocrine carcinoma of the scalp - case and review of the literature

Brown¹,

Riesco-Martinez²,

Petrella³

2016

Glob Dermatol

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A previously healthy 42 year-old woman presented at her family doctor after her hairdresser noticed a nodule in the left temporo-parietal area of the scalp. The mass was a firm, reddish nodule measuring approximately 3 × 2 cm. The patient was completely asymptomatic. She was referred to dermatology, and the lesion was excised. The initial pathology report showed a moderately-well differentiated adenocarcinoma. It was unclear at this time whether this was a primary lesion of the sweat gland or metastatic adenocarcinoma from another site. She was then referred to our centre for oncologic work-up.The pathology was reviewed and confirmed a moderately differentiated adenocarcinoma (Figure 1). The tumour was formed by single tubules or complex back to back tubular structures with areas where the luminal cells showed apical snouts. The lesion filled the reticular dermis without involving the epidermis. No perineural or lymphovascular invasion was present. The resection margins were clear, with the closest margin at 2 mm. The immunohistochemistry showed positivity for CK 7, ER, PR, Androgen receptor, CDX2, Ber ep4 and EMA. It was found to be negative for High molecular weight keratin, CK 20, COX2, CDX2, TTF1, Renal cell marker, CD 117, and CEA. It was concluded that this profile was most consistent with a metastatic breast carcinoma; however an eccrine/apocrine carcinoma of the skin could not be completely ruled out.On physical examination, there was no palpable lymphadenopathy of the neck, supraclavicular or infraclavicular regions bilaterally. No pre-or postauricular lymphadenopathy. On the left temporal parietal scalp, there was a 3 cm, well-healed scar, with no signs of infection or IntroductionPrimary cutaneous apocrine carcinoma (PCAC) is a rare type of sweat gland neoplasm with incidence rates estimated to range from 0.0049-0.0173 per 100,000 patients per year [1]. Approximately 200 total cases are reported in the literature. PCAC occurs in areas with large numbers of apocrine glands [2]. The scalp is among one of the rarest sites of occurrence, while the axilla appears most commonly [3]. Among the 186 cases reviewed by Hollowell, equal distribution was present in both males and females, with 76% of the sample population of Caucasian ethnicity. Median age was calculated at 67 years for this sample, which is the largest cohort studied to date [1].PCAC can develop in the dermal and subcutaneous layers of the skin, occasionally infiltrating the epidermal layer resulting in ulceration. PCAC has a diverse presentation, occurring as both uniand multi-nodular growths with varying colour [2]. Often these neoplasms are indurated, painless masses and can be associated with benign lesions [2], including a nevus sebaceous, most commonly seen with scalp lesions [4][5][6]. Development of these lesions typically occurs within a year before diagnosis [7]; however several cases have reported longer durations with a period of rapid growth [4,5,8,9]. PCAC is often quite difficult to differentiate from metastases of adenocarcinoma o...

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Section: Literature Review Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Treatment of primary cutaneous apocrine carcinoma of the scalp - case and review of the literature

Brown¹,

Riesco-Martinez²,

Petrella³

2016

Glob Dermatol

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“…Radiotherapy may be used in case of local recurrence or involvement of regional lymph nodes 4,11 . Systemic chemotherapy has not proved to be effective in treating these tumors, even though new studies are still ongoing 11,12 .…”

Section: Discussionmentioning

confidence: 99%

Carcinoma apócrino na glândula parótida e na região submandibular

Francisco¹,

Alfaro²,

Oliveira³

et al. 2005

Rev. Bras. Otorrinolaringol.

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The objectives of this paper are to report a case of apocrine carcinoma and the discussion of aspects related to its diagnosis, treatment, and prognosis. Carcinomas with apocrine differentiation not related to extramammary Paget's disease, ductal breast carcinoma, Moll's glands adenocarcinoma and ceruminous glands carcinoma are very uncommon tumors. We report a case of a 51-year-old black woman who developed apocrine carcinoma lesions in the head and neck region. Two lesions involved her left parotid gland (first tumor and local recurrence), and other involved her submandibular skin. The microscopic aspects were as follows: infiltrative glandular epithelial neoplasm with moderate cellular and nuclear pleomorphism; neoplasic cells with polygonal or circular shape, large nuclei and eosinophilic and granular cytoplasm. The apical decapitation secretion was viewed in a large number of intra-cystic tumor cells. Moreover, we found areas with comedo-necrosis or PAS positive staining (with or without diastase). Based on cutaneous apocrine carcinoma compatibility of the microscopic aspects, we concluded that the tumor in the submandibular skin was probably the primary neoplasm. The patient was treated by surgical excisions, and no evidence of recurrent or metastatic disease has been seen after a follow-up period of 12 months. Rev Bras Otorrinolaringol. V.71, n.2, 224-7, mar./apr. 2005

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Brain metastases from apocrine carcinoma of the scalp: case report

et al. 2005

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Apocrine carcinoma is an extremely rare malignant neoplasm that occurs most frequently in the axilla. Although it usually shows an indolent clinical course, it often metastasizes to regional lymph nodes and sometimes to lungs or bones. However, a literature search did not reveal any report describing the detailed clinical course of brain metastases from apocrine carcinoma. We report a case of a 54-year-old male who suffered from multiple brain metastases from apocrine carcinoma that had originated in the scalp 6 years before. The brain metastases appeared in spite of several regimens of chemotherapy for lung metastases for two years. The tumor in the right frontal lobe was successfully operated. However, the small tumor in the right occipital lobe was not cured by gamma knife surgery, and eventually required second operation. The operation had contributed to his neurologically independent life for about one year until he died for gradual progression of lung metastases. To our knowledge this is the first reported case of metastatic brain tumor from apocrine carcinoma.

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

Cited by 32 publications

References 12 publications

Treatment of primary cutaneous apocrine carcinoma of the scalp - case and review of the literature

Treatment of primary cutaneous apocrine carcinoma of the scalp - case and review of the literature

Carcinoma apócrino na glândula parótida e na região submandibular

Brain metastases from apocrine carcinoma of the scalp: case report

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