Metastatic sweat gland adenocarcinoma: A clinico-pathological dilemma

Abstract

BackgroundSweat gland adenocarcinoma is a rare malignancy with high metastatic potential seen more commonly in later years of life. Scalp is the most common site of occurrence and it usually spreads to lymph nodes. Liver, lung and bones are the distant sites of metastasis with fatal results. The differentiation between apocrine and eccrine metastatic sweat gland carcinoma is often difficult. The criteria's are inadequate to be of any practical utility.Case ReportTwo cases of metastatic sweat gland adenocarcinoma (one of eccrine and the other one of apocrine origin) are being reported on account of the rarity and different outcome.ConclusionSweat gland carcinomas are rare cancers with a poor prognosis often presenting as histological surprises. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Chemotherapy and/or radiotherapy has limited role.

Wide excision and reconstruction surgery for recurrent sweat gland umbilical adenocarcinoma followed by chemotherapy can prevent the risk of recurrences

“…A broader excision may prevent recurrence [3, 7]. The main reason we did surgery with a 5.0 cm margin was that our case is a recurrent sweat gland umbilical adenocarcinoma, and needed a wider excision to prevent its recurrence.…”

“…The predilection of this tumor is in the genital skin and perineum (34.5%), trunk (26.4%), head and neck (18.3%) and lower extremities (13.9%) [3]. Adenocarcinoma of sweat glands appears as moderate to poor adenocarcinoma with regional variations, ranging from true ductile form to infiltrative anaplastic form.…”

Primary apocrine carcinoma of the axilla in a male patient: a case report

“…The adenocarcinoma contains ductal or glandular structures with apocrine features. The cytoplasm of the tumor cells contains periodic acid–Schiff‐positive, diastase‐resistant granules and often iron‐positive granules 3, 5, 9. Robson et al 2 suggested that apocrine carcinoma can be diagnosed mainly by its hallmark histologic features, such as abundant granular, eosinophilic cytoplasm with luminal decapitation secretion.…”

Primary apocrine sweat gland carcinomas of the axilla: a report of two cases and a review of the literature

“…Despite the fact that regional lymph node metastases are found in nearly 50% of patients with PASGC at the time of diagnosis, the benefit of performing prophylactic regional lymph node dissection in patients with no clinical evidence of lymph node metastasis remains controversial. Some studies have shown that prophylactic lymph node dissection has no influence on survival or disease recurrence in PASGC patients [ 2 , 4 ]. However, several case reports have found that sentinel lymph node (SLN) biopsy is useful in these patients.…”

“…In the largest retrospective cohort study of PASGC, the median overall survival and 5-year disease-specific survival rate were 51.5 months and 88%, respectively [ 1 ]. The prognostic factors for PASGC are difficult to identify because of the small number of reported cases, but the possible factors include tumor size, histological type, lymph node involvement, and distant metastasis [ 4 , 5 ]. Here, we report two cases of locally advanced PASGC that arose in the axilla, which is the most common site of PASGC.…”