Facial Apocrine Fibroadenoma in Man: A Rare Finding

Abstract

Apocrine fibroadenoma (AFA), considered a counterpart of fibroadenoma of breast, is a rare cutaneous apocrine neoplasm occurring almost exclusively in women. We describe a 75-year-old man who presented with a red dome-shaped papule near the nasal bridge. The tumor was composed of numerous tubular, cystic, and partially branching lumina and struts of epithelial cells oriented perpendicular to the skin surface, with which it connected through infundibula. The epithelial strands were embedded in fibrocollagenous stroma. These histopathological features are consistent with AFA. The cytokeratin profiles of our case were similar to those of apocrine or eccrine neoplasms. Progesterone and estrogen receptors (PR/ER) were not expressed. The stroma cells were stained strongly positive for vimentin, but nonreactive for alpha-smooth muscle actin, S-100 protein, or glial fibrillary acidic protein. To the best of our knowledge, this is the first report of facial AFA in man. Different from a more common anogenital AFA, this neoplasm might represent a second type of AFA with unique histopathologic and immunopathological features.

Apocrine Fibroadenoma on the Face

“…11 In 1991, van der Putte 12 introduced the idea of mammary-like anogenital glands as a normal constituent of the anogenital area. 2,5 The other reported cases did not have immunohistochemical staining performed. Located between the labia minora and labia majora, posteriorly in the paramedian zone of the perineum and around the anus, these structures were postulated to give rise to tumors resembling mammary gland neoplasms.…”

“…These mammary-like anogenital glands express hormone receptors detected by immunohistochemistry. 2,5,6 It may be that these neoplasms arise from local eccrine glands transformed to apocrine glands with the ability to form acini-like mammary glands. 11 Other than the fibroadenomas found in the anogenital region, to our knowledge, there have only been 5 reported cases (including the current case) of fibroadenomas elsewhere in the body (Table 1).…”