Cutaneous Apocrine Carcinoma With an In Situ Component and Histiocytoid and Signet-Ring Cells

Abstract

We present a case of cutaneous apocrine carcinoma arising in the axilla of a 71-year-old man. The tumor had a significant component of histiocytoid and signet-ring cells as well as in situ carcinoma within the apocrine glands. The cells expressed GATA3, gross cystic disease fluid protein 15, androgen receptor, and E-cadherin. Estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 were negative. Clinical correlation was required to rule out a metastasis from the breast or the gastrointestinal tract. Although most cutaneous apocrine carcinomas do not behave aggressively, our patient developed bone metastases and eventually died of his disease. It is debated whether histiocytoid and signet-ring cell cutaneous carcinomas should be classified as apocrine neoplasm. The presence of in situ carcinoma associated with this kind of tumor has been reported only once in the literature. This characteristic and the immunohistochemical profile are in favor of apocrine differentiation.

Signet‐ring cell/histiocytoid carcinoma of the axilla: a clinicopathological and genetic analysis of 11 cases, review of the literature, and comparison with potentially related tumours

“…However, our study indicated that lymph node metastasis is seen more frequently in axillary SRCHC cases than in eyelid SRCHC cases [8/11 (73%) versus 1/4 (25%)], even though eyelid SRCHC cases had larger tumours in our study. A literature review also revealed the predominance of axillary SRCHC [10/14 (71%) versus 8/43 (19%)] 2,3,5–7,14–51,54,55 . Distant metastasis was seen in approximately half of both axillary and eyelid SRCHC cases [5/11 (45%) versus 2/4 (50%)].…”

“…These were similar to those for conventional AC 52,53 . There were no SRCHC cases located in areas other than the axilla and eyelid 2,3,5–7,14–51,54,55 . Thus, metastasis should be considered for cases arising at other sites.…”

“…Data on 11 cases of axillary SRCHC (cases 1-11), four cases of eyelid SRCHC (cases 12-15), eight cases of conventional primary AC of the axilla (cases [16][17][18][19][20][21][22][23], one case of ILC arising in the supernumerary mammary tissue of the axilla (case 24), and four cases of ILC arising in the upper outer quadrant breast area close to the axilla (cases 25-28) were retrieved from the authors' seven institutions (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020). The histopathological diagnoses of all 28 cases were reconfirmed by at least two authors.…”

“…The clinical data of the present cases, including axillary signet-ring cell/histiocytoid carcinoma (SRCHC) (cases 1-11), eyelid SRCHC (cases 12-15), conventional apocrine carcinoma (cases[16][17][18][19][20][21][22][23], and supernumerary mammary carcinoma (case24) …”

Periocular Histiocytoid Carcinoma: Potential Diagnostic Challenges

“…Metastases have occurred in around half of the reported cases, usually to nearby lymph nodes [2,12]. Tumor-related deaths have also been described [6,13,18,19]. The periorbital lesions often present as diffuse swelling and thickening of the involved lid, with normal or erythematous skin, and tend to infiltrate circumferentially around the eyelid, leading to their "monocle-like" appearance [20].…”