GATA3-Positive Adnexal Adenocarcinoma: Report of a Confusing Case with a Potential Pitfall of Leading to a Misdiagnosis of Urothelial Carcinoma and a Review of Published Work

Abstract

We describe a confusing case of GATA3-positive adnexal adenocarcinoma with a potential pitfall of leading to a misdiagnosis of urothelial carcinoma. A 62-year-old male presented with a subcutaneous nodule on the right lower abdomen around a scar from surgery for urothelial carcinoma in the right urinary tract, which had been resected 8 years previously. Histologically, atypical cells possessing ample cytoplasm and partial intracytoplasmic lumens were densely grouped in the subcutaneous expansive nodule and bilateral inguinal lymph nodes dissected. Decapitation secretion could not be seen. Neoplastic cells were positive for CK7, GATA3, and GCDFP15, and negative for CK5/6, CK20, p63, CD10, PAX8, HER-2, and uroplakin-Ⅱ. Neoplastic cells in the urothelium and the metastasized lung were positive for CK7, CK5/6, and GATA3, and negative for CK20, p63, GCDFP15, and TTF-1. A variable level of GATA3 expression in malignant tumors with apocrine and eccrine differentiation should be recognized by dermatologists. (Ann Dermatol 32(5) 417∼ 421, 2020

Intraepidermal Poroma (Hidroacanthoma Simplex) Versus Clonal Seborrheic Keratosis: Will GATA3 Immunohistochemistry Help in the Differential Diagnosis?

“…In their data, 33% (n = 3/9) of poromas stained positively, and the lone example of porocarcinoma lacked GATA3 expression (n = 1). In 2017, a separate study was conducted by Pardal et al 9 to further characterize GATA3 expression in skin adnexal tumors, including poromas (20%, n = 1/5) and porocarcinomas (43%, n = 10/23), which was supported in a case and review conducted by Kiyohara and Tanimura 10 Practicing pathologists have encountered many "magic" determinants that seem to exhibit their greatest specificity for a brief period postpublication. Our case, with morphological and immunohistochemical features simulating CSK, instead represents a sweat gland tumor (i.e., porocarcinoma in situ arising in a long-standing poroma) and suggests that GATA3 may not be as specific or diagnostically informative in the distinction of these entities as stated by Lin et al…”

MCATs: Case report of adnexal adenocarcinoma of not otherwise specified type

“…To clarify the histogenesis of the tumor and determine the immunophenotype of tumor cells, an immunohistochemical study was performed (Figure 2). Also, the reason for additional immunohistochemical studies was the frequent metastasis of malignant tumors of other localizations into the skin 3 . When conducting an immunohistochemical study, most of the tumor cells were positive for the following markers—CK7, GATA 3 (L50‐853), GCDSP‐15, mammaglobin A&B and negative for CK 5/6.…”

“…GCDFP‐15 is reported to be of cutaneous or mammary origin. In addition, tumor cells showed a positive reaction of varying degrees of intensity to ER and PgR receptors 3 . Since the histological picture, as well as the immunophenotype of the tumor, was similar to non‐specific type ductal carcinoma of the breast, 5 additional targeted clinical studies of mammary lesions were carried out.…”

“…In addition, tumor cells showed a positive reaction of varying degrees of intensity to ER and PgR receptors. 3 Since the histological picture, as well as the immunophenotype of the tumor, was similar to non-specific type ductal carcinoma of the breast, 5 additional targeted clinical studies of mammary lesions were carried out. Considering all the data we diagnosed adnexal adenocarcinoma of not otherwise specified type.…”

“…Also, the reason for additional immunohistochemical studies was the frequent metastasis of malignant tumors of other localizations into the skin. 3 When conducting an immunohistochemical study, most of the tumor cells were positive for the following markers-CK7, GATA 3 (L50-853), GCDSP-15, mammaglobin A&B and negative for CK 5/6. GATA3 target gene promoters are involved in epidermal differentiation, and in the skin barrier function, as well as in the differentiation of the mammary glands and the urothelial tract and the regulation of T-cell differentiation.…”